PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Reproductive Health”

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 145 records · Page 8Linked to original sources

Reproductive health in Romania: reversing the Ceausescu legacy.

As a result of the restrictive reproductive health policies enforced under the 25-year Ceausescu dictatorship, Romania ended the 1980s with the highest recorded maternal mortality of any country in Europe--159 deaths per 100,000 live births in 1989. An estimated 87 percent of these maternal deaths were caused by illegal and unsafe abortion. Under the Ceausescu regime, all contraceptive methods were forbidden and induced abortion was available only for women who met extremely narrow criteria. Immediately after the December 1989 revolution that overthrew Ceausescu, the new government removed restrictions on contraceptive use and legalized abortion. This legislative change has had beneficial effects on women's health, seen in the drop in maternal mortality in 1990 to 83 deaths per 100,000 live births--almost half the ratio in 1989. In addition, changes instituted since the revolution have led to the improved availability of reproductive health services and to the creation of new educational and training opportunities related to reproductive health services and to the creation of new educational and training opportunities related to reproductive health. The newly created contraceptive and abortion services have presented health system managers and policymakers with many challenges as they work to expand the availability of high-quality, comprehensive reproductive health care in a setting of economic hardship, political unrest, insufficient infrastructure, and outdated medical knowledge and practice.

Abortion, Legal↗

An overview of reproductive health of women in Bajhang district.

Reproductive health is not merely an absence of disease or disorder, rather it is a condition in which reproductive process is accomplished in a state of complete physical, mental and social well being according to WHO. Reproductive morbidity encompasses obstetric morbidity including conditions during pregnancy, delivery and the post-partum period; and gynecological morbidity including conditions of the reproductive tract such as reproductive-tract infections, cervical cell changes, genital prolapse, malignancies and infertility. The first step towards achieving the needs of women as consumers and providers is to do baseline research so that the nature and magnitude of the problem is assessed. Bajhang is one of the poorest, most deprived and remotest districts in the Far Western development region of Nepal. The status of all women is very low and their situation is very difficult. This study was conducted during a gynecological camp for a period of six days from 10th-15th March, 2003, in the district hospital of Bajhang at Chainpur. All women who attended the gynecological camp were included in the study. The 6 days period, total 530 women had attended the camp. Among them 273 (51.5%) had gynecological problems. Uterovaginal prolapse was the leading morbidity found in 97 women (18.3%) followed by subfertility (14.2%) and reproductive tract infections(13.9%). Only 22.0% women were using family planning methods. This study shows that a large number of women are seeking help for gynecological problems, hence emphasizing the importance of research in this area. Such studies have a pronounced impact in settings where no information on gynaecological morbidities exists and where there is an absence of consensus on the extent of such morbidity. This study not only gives us a baseline data about the most prevalent gynaecological problems in the remote area, it may help us in planning future reproductive health programs also.

Adolescent↗

[Management and performance of human resources in reproductive health services].

For most people, utilizing reproductive health services is colored by strong emotional and subjective implications. Therefore, it is essential to know the local situation well when planning those services and designing activities directed toward the community. User satisfaction also depends on allowing those persons to participate in solving problems from their own perspective and on the treatment they receive from health service personnel. It's impossible to overstate the importance of the performance of health care providers and, accordingly, the management of those personnel. This article presents general principles that govern such management, the tasks that management entails, and the most desirable attitudes in reproductive health service providers.

Community Health Services↗

[From industrial hygiene for women to the protection of the reproductive health of workers. Principles and outlook].

The issues and prospects of workers' reproductive health as a problem of occupational health in nowadays Russia are outlined with due account for WHO, ILO, EC, etc. concepts and recommendations. Main principles of reproductive health protection are gender approach, additional protection of vulnerable groups, e. g. pregnant women and obligatory account for combined effects of occupational, environmental and socio-economic risk factors. Two groups of criteria are essential: criteria of health and criteria of emancipation. Criteria for evaluation of reproductive health disorders are worked out based on official statistical indices and it is proposed to rate some of these as of extra category class for effective risk assessment and risk management. The strategy and priorities in workers' reproductive health are discussed and need for international cooperation is noted for resolving this problem.

Adolescent↗

Serving rural Australia with reproductive health expertise.

This study aimed to review the use of reproductive health services in Family Planning clinics by women from rural (non-metropolitan) Australia through a retrospective analysis of data collected at clinics of seven state/territory Family Planning Organisations (FPO). From a total of 146 157 client visits to FPO clinics between July 1998 and June 1999, 42 497 (29.1%) were by clients who lived outside metropolitan areas. Some 97% of clients were women. Our results show the use of reproductive health services by women from rural areas was different from the services used by women from metropolitan areas. There were fewer male clients, more women over 40 years of age, and fewer clients from a non-English speaking background. More of the attendees had pension cards and fewer were privately insured. We concluded there is considerable demand for reproductive health services among the rural population and reproductive health care needs to be expanded to reach rural women.

Adult↗

The impact of decentralisation on sexual and reproductive health services in Ghana.

This paper analyses the impact of decentralisation on the political organisation, management and provision of sexual and reproductive health services in Ghana. It draws on qualitative research and interviews with key informants from the Ministry of Health, donors, NGOs, regional and district health management teams, local government and community leaders. Within a national reproductive health policy framework, previously disparate family planning, maternal and child health, STI and HIV/AIDS programmes have become more integrated, and donors have pooled or co-ordinated their funding. Some decision-making about resource allocation is meant to happen at district and regional level but in practice, this remains centrally controlled, which may be a necessary safeguard for sexual and reproductive health services. Earmarked donor funds still ensure a regular supply of contraceptives and STI drugs. However, paying for these is problematic at local level. Sexual and reproductive health staff make up a large proportion of primary health care staff, but especially in rural areas they experience poor working conditions, and there is high turnover and vacancies. District and sub-district level links are working well in this new system, but clarity is still needed on how different national sexual and reproductive health bodies relate to each other and to regional and district health authorities. The development of formal mechanisms for priority setting and advocacy at local levels could help to secure benefits for sexual and reproductive health care.

Attitude of Health Personnel↗

Interest holder-driven research priorities in sexual and reproductive health for migrant and refugee adolescents and young adults in Australia.

OBJECTIVE: To identify and prioritise sexual and reproductive health research priorities for migrant and refugee adolescents and young adults in Australia using a priority setting partnership approach. METHODS: A James Lind Alliance priority setting partnership was conducted with 92 interest holders: 31 youth from migrant and refugee backgrounds and 61 professionals (healthcare providers, researchers, policymakers and community leaders), recruited online and in-person. The priority setting partnership process included a rapid evidence scan, an online uncertainty survey, evidence verification, interim prioritisation and a final consensus workshop. RESULTS: Eighty-three research uncertainties yielded 11 final priorities across four sexual and reproductive health domains: sexual and reproductive health literacy, sexual violence prevention, accessible services and maternal health. A striking divergence emerged between youth and professional priorities only 3 achieved combined high-priority consensus. Youth prioritised a broader range of topics, including abortion access (rated high by youth but low by professionals), while professionals prioritised fewer areas. Two priorities achieved consensus: community-based maternal health support and barriers to reporting gender-based violence. CONCLUSION: This is the first priority setting partnership to identify sexual and reproductive health research priorities for migrant and refugee youth in Australia and to uniquely highlight substantial misalignment between youth and professional priorities. IMPLICATIONS FOR PUBLIC HEALTH: These identified priorities provide a foundation for targeted research, culturally responsive policy and more equitable sexual and reproductive health service provision for migrant and refugee adolescents and young adults.

Australia↗

Real and perceived threats to reproductive health: a way forward.

Ten years ofter the International Conference on Population and Development finds the reproductive health community under threat from at least three sources: global initiatives, reforms of the health sector, and new financial modalities from donors and lenders. These challenges, however, mainly reflect the complete system failure in many low-income countries in providing basic reproductive health services to women, especially those who are poor and socially vulnerable. The reproductive health community can do a lot more to address the system failures and potential threats and take advantage of opportunities offered. The starting point should be an internal look at how the reproductive health community has performed in helping low-income countries. Understanding these changes and opportunities in the health sector is another important step, but understanding will only be effective if representatives of the reproductive health community in low-income countries are armed with the skills and tools needed to engage in health sector reforms, to take advantage of global initiatives and to effectively influence the implementation of new holistic forms of aid.

Developing Countries↗

From population control to reproductive health: an emerging policy agenda.

This article reviews the background to the current debates between advocates of population control and reproductive health as frameworks for national and international health policies. Population control has been a dominant metaphor in international family planning programs since the 1960s. Population control has frequently meant pursuing a single-minded goal of fertility limitation, often without sufficient attention to the rights of family planning clients. This narrow focus has led to some coercive policies, numerous ethical violations, and ineffective family planning programs. In the last decade there has been the beginning of a policy shift, advocated by a growing number of activists and researchers in women's health, from population control to reproductive health. A reproductive health framework would provide a broader programmatic focus that could bring needed attention to such issues as sexually transmitted diseases, infertility, abortion, reproductive cancers and women's empowerment generally.

Female↗

Women's reproductive health: recent advances in therapies.

Normal cyclic menstruation involves a delicate concert of hormonal events, characterized by midcycle ovulation and, if no pregnancy is achieved, menstrual flow. Women's health--and especially their reproductive health and fertility--may be affected by abnormalities in cyclicity or in menstruation. A number of valuable modes of therapy have recently become available. Abnormal cyclicity may be caused by decreased estrogen levels (from exercise, smoking, or eating disorders). Small ovulation induction pumps, which deliver minute physiologic concentrations of gonadotropin-releasing hormone (GnRH) around the clock, can be used for safe and successful treatment. Increased estrogen levels may also affect cyclicity, and may be suppressed with new GnRH antagonists or stimulated to cyclicity with pure follicle-stimulating hormone. Abnormal menstruation may be caused by intrauterine scarring or fibroids. Outpatient hysteroscopic surgery may successfully and conservatively be used to treat these problems. Today, even women who have been born without a uterus or who have undergone hysterectomy may have a child through a host uterus program. This combines in vitro fertilization of the husband's sperm with his wife's egg with transfer of the embryo into a host who is capable of carrying the pregnancy. Our potential to improve women's reproductive health continues to expand, as some of the recent developments described above for treating abnormalities of cyclicity or menstruation attest.

Female↗

Reproductive health indicators and outcomes among refugee and internally displaced persons in postemergency phase camps.

CONTEXT: Despite increasing awareness of the importance of reproductive health programs and services for refugee and internally displaced populations, there is a paucity of basic epidemiological data on reproductive health outcomes. OBJECTIVES: To collect data on reproductive health outcomes among refugees and internally displaced persons in postemergency phase camps and compare these outcomes with those of host country and country-of-origin populations. To determine programmatic factors that may affect reproductive health outcomes. DESIGN, SETTING, AND PARTICIPANTS: Retrospective study of data collected from August 1998 through March 2000 of 688,766 persons living in 52 postemergency phase camps in 7 countries. Reproductive health outcomes of refugee and internally displaced populations were compared with available data of reference populations within their respective host country and country of origin. MAIN OUTCOME MEASURES: Crude birth rate (CBR), neonatal mortality rate (NNMR), maternal mortality ratio (MMR), percentage of newborns with low birth weight (LBW), and incidence of complications of unsafe or spontaneous abortions. RESULTS: Six of 11 groups had lower CBRs than their country of origin and 5 of 9 groups had lower CBRs than their host country. Four of 5 had lower NNMRs than their country of origin and 6 of 9 had lower NNMRs than the host country. Four of 6 had lower MMRs than their country of origin, and 5 of 6 had lower MMRs than their host country. Seven of 9 had lower percentages of LBWs than in the country of origin and 5 of 9 had lower percentages of LBWs than the host country. Higher CBRs were associated with more recently established camps and higher numbers of local health staff per 1000 persons; and higher percentages of LBW newborns were associated with rainy season, more recently established camps, lower numbers of community health workers per 1000 persons, and camps without supplementary feeding programs. CONCLUSIONS: Refugees and internally displaced persons in most postemergency phase camps had better reproductive health outcomes than their respective host country and country-of-origin populations.

Abortion, Illegal↗

Selection of reproductive health end points for environmental risk assessment.

In addition to the challenges inherent in environmental health risk assessment, the study of reproductive health requires thorough consideration of the very definition of reproductive risk. Researchers have yet to determine which end points need to be considered to comprehensively evaluate a community's reproductive health. Several scientific issues should be considered in the selection of end points: the severity of the outcomes, with a trade-off between clinical severity and statistical or biological sensitivity; the relative sensitivity of different outcomes to environmental agents; the interrelationship among adverse outcomes; the baseline frequency of the adverse outcome; evidence from reproductive toxicology; and specificity of reproductive effects from the environmental agent. Simultaneously, practical concerns should be addressed: frequency of occurrence of an event and consequent statistical power to evaluate changes; frequency of prerequisites (e.g., pregnancy) that are necessary to be at risk; time and money resource requirements for measuring the outcome; amenability of the end point to retrospective measurement; and burden of measurement on the population being studied. In this article, we discuss these scientific and practical considerations and recommend that reproductive risk assessment include measures of fecundability (menstrual function, time to pregnancy), fetal loss (clinically recognized miscarriage), and infant health (birth weight, gestational age). Additional methodological research is needed to refine the array of reproductive health measures that need to be examined as a consequence of environmental exposures.

Environmental Exposure↗

Sexual behaviors and reproductive health outcomes: associations with wife abuse in India.

CONTEXT: Wife abuse has been associated with a variety of health concerns. Associations between abuse and reproductive health in India are not well known. OBJECTIVE: To examine relationships between men's reports of wife abuse and reproductive health issues in northern India. DESIGN: Structured face-to-face interviews were conducted as part of the male reproductive health supplement of the PERFORM System of Indicators Survey, a systematic multistage survey conducted in 1995-1996. SETTING: The northern state of Uttar Pradesh, one of the least developed states in India. PARTICIPANTS: A total of 6632 married men aged 15 to 65 years who lived with their wives and completed all survey questions for the study variables reported here. MAIN MEASURES: Physically and sexually abusive behaviors toward wives, sexual activities outside marriage, sexually transmitted disease (STD) symptoms, contraception use, unplanned pregnancies, and sociodemographic characteristics. RESULTS: Fifty-four percent of men reported not abusing their wives, while 17% reported physically but not sexually abusing their wives, 22% reported sexual abuse without physical force, and 7% reported sexual abuse with physical force. Abuse was more common among men who had extramarital sex (for sexual abuse using force: odds ratio [OR], 6.22; 95% confidence interval [CI], 3.98-9.72). Similarly, men who had STD symptoms were more likely to abuse their wives (with current symptoms: OR, 2.43; 95% CI, 1.73-3.42). Unplanned pregnancies were significantly more common among wives of abusive men, especially sexually abusive men who used force (OR, 2.62; 95% CI, 1.91-3.60). CONCLUSIONS: Wife abuse appears to be fairly common in northern India. Our findings that abusive men were more likely to engage in extramarital sex and have STD symptoms suggest that these men may be acquiring STDs from their extramarital relationships, thereby placing their wives at risk for STD acquisition, sometimes via sexual abuse. These abusive sexual behaviors also may result in an elevated rate of unplanned pregnancies.

Adolescent↗

The implementation of reproductive health programs: experiences, achievements and challenges.

As a fundamental element of population strategies for international development, reproductive health has received much recognition since the International Conference on Population and Development held in Cairo in 1994. Nevertheless, much remains to be done to improve the understanding of the concept of reproductive health, support reproductive rights, operationalize reproductive healthcare within basic health services and promote a more conducive social, cultural and economic environment, especially for women and girls, to enable the attainment of reproductive health. Collaboration between governments and non-governmental organizations will be crucial and obstetrician-gynecologists have a unique role, through service provision, review of regulatory frameworks, education and advocacy, for the promotion of reproductive health.

Delivery of Health Care↗

The assessment of reproductive health services: a conceptual framework for prenatal care.

This article delineates a conceptual model for defining and measuring quality in prenatal services. It addresses three issues related to women's health: (a) the emerging interest in reproductive health as a concept that encompasses the full range of women's needs, versus the more narrow concept and approach of traditional maternal and child health services; (b) the importance of prenatal services within the context of reproductive health, particularly in developing countries; and (c) the positive role that quality plays in promoting women's health. It then proposes a model for defining and measuring quality in prenatal services, styled after Donabedian's work and informed by Bruce's framework. It assesses the quality of prenatal care in terms of five elements: management, pregnant woman-provider relations, technical competence, information transmission, and continuity of care. The framework was tested in the city of Irbid, Jordan, in 1992. Findings are summarized, and recommendations for future work as discussed.

Female↗

Planning reproductive health in conflict: a conceptual framework.

A conceptual framework for planning reproductive health services for refugees is presented for use by those involved in planning field activities. Secondary sources of data are recommended to describe pre-existing patterns and trends in reproductive health status and likely determinants of any change in status, for populations which have been subsequently affected by conflict. The interaction between these patterns and the conflict itself is then analyzed, taking into account the shift in health status and service availability as the conflict progresses through various recognized phases. The potential impact of conflict is thus hypothesized in order to make initial plans for incorporating reproductive health services into standard relief packages. Two case studies are presented: Rwanda demonstrates the use of the framework in a relatively short but dramatic conflict, for which there was also substantial prior evidence on reproductive health status; Cambodia is used, in contrast, to demonstrate the use of the framework in a much more complex conflict which has been occurring over the last 20 years.

Cambodia↗

[Breakthroughs in the study of the influence of environmental factors on male reproductive health].

BACKGROUND: An important part of the research effort on male reproductive health focus on two important questions: on the one side, that of the temporal deterioration of male reproductive health and, on the other head, that of the influence of exposure to environmental chemicals during intra-uterine life on health during childhood and adulthood. The concepts on endocrine disruption and testicular dysgenesis syndrome make a link between these two questions. METHODS: This work examines knowledge cumulated over the last couple of years concerning geographical and temporal variations in male reproductive health and the testicular dysgenesis syndrome. Recent results concerning the concept of endocrine disruption and on the environmental influences on male reproduction are presented, as well as on the transgenerational effects on environmental factors on the health of male children. CONCLUSIONS: Based on clinical and epidemiological data, and with the use of in vitro animal models as well as observations in wildlife, research in this field has enabled progress in the elucidation of mechanisms of action and characterization of environmental influences on male reproductive health.

Environmental Exposure↗

Reproductive health problems and help seeking behavior among adolescents in urban India.

OBJECTIVE: To assess their reproductive health problems and help seeking behaviour among urban school going adolescents. METHOD: A sample of 300 urban school going adolescents between 11-14 years were chosen at random and assessed using four tools namely, self administered questionnaire : provision of adolescent friendly services; medical screening and focus group discussions. RESULTS: Seventy two percent girls and 56% boys reported health problems during survey with an average of 1.93 complaints per girl and 0.5 complaints per boy. However, only 43% girls and 35% boys reported to the clinic voluntarily to seek help and only one fifth the amount of problems were reported at the clinic in comparison to the quantum of problems reported in survey, which probably reflects a poor health seeking behaviour. A medical checkup with emphasis on assessment of reproductive health and nutritional status helped in detecting almost the same number of reproductive health problems as reported by them in survey. This intervention helped to increase the client attendance in subsequent period of next one year from 43% to 60% among girls and from 35% to 42% among boys. CONCLUSION: Our study shows that to increase help seeking behaviour of adolescents, apart from health and life skill education, their medical screening with a focus on reproductive health by trained physicians, parental involvement, supported by adolescent friendly centers (AFC) for counseling, referral and follow up are essential.

Adolescent↗