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PubMed2006

Sexual behavior and experience of sexual coercion among secondary school students in three states in North Eastern Nigeria.

BACKGROUND: Interest in the reproductive health of adolescents continues to grow throughout the world. Few studies had explored the reproductive health knowledge, sexual behavior and experience of sexual coercion among secondary school students in North Eastern states of Nigeria. The objectives of this descriptive survey were to collect data to plan appropriate interventions that meet the reproductive health knowledge, service and skills needs of students in Bauchi, Borno and Gombe states. METHODS: Face-to-face interviews were conducted for 624 consenting students who were randomly selected from eighteen secondary schools using an 83-item structured questionnaire. Data were collected on demographic profile, reproductive health knowledge, sexual behavior and experience of sexual coercion. RESULTS: The mean age of the respondents was 16.5 years. There were slightly more males (52%) than females (48%). Students' knowledge about reproductive health was generally low even though girls had better knowledge than boys. Thirteen percent of the entire students had had sexual experience; significantly more males (19%) than females (6%) had done so (p < 0.001). Among boys the age at sexual debut ranged from 10-26 with a mean of 15.7 and median of 16. By contrast, the age at first sex among girls ranged from 10 to 18 years with a mean and median of 16.1 and 17 years respectively. Only 24% of those who were sexually active used a condom during their last sexual encounter. Overall 11% of the students reported that they had been tricked into having sex, 9% had experienced unwanted touch of breast and backside, and 5% reported rape. CONCLUSION: Students low reproductive health knowledge and involvement in risky sexual activities predispose them to undesirable reproductive health outcomes.

Adolescent↗
PubMed2005

Sexual health promotion in Thailand.

Sexuality and power are at the root of most sexual and reproductive health problems in Thailand, including reproductive tract infections, fertility and population control, unwanted pregnancy and abortion, unsafe abortion, unsafe motherhood and violence against women, as well as issues emerging from the mobile and migrant population, including the spreading of HIV/AIDS. In the past three decades, reproductive health services in Thailand have been established and strengthened. Since 1995, reproductive health has become a priority of the Ministry of Public Health. Health system reform in 2000 led to strategies and actions of health performance improvement. Ongoing multisectoral programmes include: (1) political and social involvement; (2) training for professionals; (3) multidimensional services; and (4) research.

Developing Countries↗
PubMed2001

Reproductive health-seeking by married adolescent girls in Maharashtra, India.

In India, most adolescent girls 15-19 years old are married. A study was conducted in 1995-97 in Ahmednagar district of Maharashtra, India to gain insight into whether and how their reproductive health needs are met, especially for gynaecological problems, family planning and perceived fertility problems. It included a survey among 302 married girls of this age, and in-depth interviews with 74 girls, 37 husbands and 53 mothers-in-law. Girls were treated quickly for illnesses interfering with domestic work and were expected to conceive in the first year of marriage. Menstrual disorders and symptoms of reproductive tract infection often went untreated. There was an emerging need for delaying and spacing pregnancies; limiting the number of children was well established. Household work, protection of fertility and silence arising from embarrassment related to sexual health problems were the strongest factors influencing care-seeking. Husbands made the decision whether their wives could seek care and mothers-in-law sometimes influenced these decisions; girls had neither decision-making power nor influence. This study provides valuable input for the new reproductive and child health programme in Maharashtra.

Adolescent↗
PubMed1996

Women's health and reproductive rights: Romanian experience.

One of the most dramatic chapters in the history of women's reproductive rights ended in Romania in 1989. For over 23 years, Romania had pursued a rigidly enforced pronatalist policy, banning the importation of contraceptives, strictly prohibiting most abortions, and imposing a tax on childless couples. The aim of this study was to explore, through individual in-depth interviews, psychosocial antecedents and consequences of the Romanian policy. The study group consisted of 50 women, aged between 18 and 55 years, with diverse sociodemographic and educational characteristics. The interviews focused on sexuality education, sexual experiences, reproductive events, and partner relations. The results show that women's private behavior and efforts to regulate their fertility prevailed over public policies, regardless of personal risks or costs to health. Concluding observations summarize major findings, results from a 1993 national household survey on reproductive health, and a commentary on the need for ongoing sexuality and contraceptive education and counseling.

Adolescent↗
PubMed2005

Traditional herbal remedies used in the management of sexual impotence and erectile dysfunction in western Uganda.

BACKGROUND: The utilisation of ethnobotanical indigenous knowledge is vital in male sexual reproductive health care delivery in western Uganda. Reproductive health care is the second most prevalent health care problem in Africa. However, this concept of reproductive health care has been focusing mainly on women disregarding men. Thus, some diseases such as sexual impotence and erectile dysfunction that deserve mention are regarded as petty though important in economic productivity, family stability and sexually transmitted diseases control including HIV/AIDS. OBJECTIVE: This study was carried out mainly to document medicinal plants used in the treatment of sexual impotence and erectile dysfunction disorders in western Uganda. METHODS: The medical ethnobotanical indigenous knowledge were collected by visiting traditional healers and documenting the medicinal plants used and other socio-cultural aspects allied with sexual impotence and erectile dysfunction. The methods used to collect the relevant information regarding the medicinal plants used included informal and formal discussions, field visits and focused semi-structured interviews. RESULTS: Thirty-three medicinal plants used in the management of sexual impotence and erectile dysfunction were documented and Citropsis articulata and Cola acuminata were among the highly utilized medicinal plants. CONCLUSION: From the researchers' point of view, the usage of herbal remedies in managing male sexual disorders is useful because of long cultural history of utilisation and the current renewed interest in natural products to sustain health globally. As a way recognising the values and roles of traditional medical knowledge in health care provision, further research into the efficacy and safety of herbal remedies in male sexual disorders is precious in Uganda and beyond. More so, the establishment of rapport between relevant government department in Ministry of Health, modern health workers through collaborative and networking ventures with traditional healers under close supervision and monitoring of herbal treatments is noble.

Erectile Dysfunction↗
PubMedDate not supplied

Trends in women's health services by type of physician seen: data from the 1985 and 1997-98 NAMCS.

As managed care enrollment has increased, controversy has arisen about the role of internists (IM), family physicians (FP), and obstetrician/gynecologists (ob/gyns) in the provision of women's health care. Efforts to improve training in women's health needs have also increased. Yet it is unclear how these trends have affected practice. We used the National Ambulatory Medical Care Survey (NAMCS), a nationally representative sample of office-based medical visits, to examine by physician specialty a) trends in the proportion of visits for women's health care and b) the content of nonillness care. Between 1985 and 1997-98, market share of reproductive health services increased for IMs (e.g., from 3.7% to 10.5% of contraceptive visits, p <.05) and decreased for FPs (from 30.5% to 20.5% for contraceptive visits, p <.05). Ob/Gyns increased their share of women's health care visits, with reproductive health visits increasing from 56.2% to 65.9% (p <.0001). The trend in hormone replacement therapy visits differed, with nonsignificant gains in market share for IMs and decreases for ob/gyns. Nonillness care (1997-98 data only) differed predictably by specialty, with IMs and FPs more often providing cholesterol screening while ob/gyns more often provided reproductive health services. Compared with IMs and FPs, ob/gyns were more likely to counsel women on reproductive health topics and equally likely to counsel on general health topics, but additional time spent in counseling was lower. Specialty differences in the provision of women's health services continue, though the scope of care provided by IMs has broadened. Still, women are unlikely to obtain a full range of preventive services in a single nonillness visit. Ensuring adequate coordination among physicians providing primary care to women continues to be a critical concern.

Adult↗
PubMed2005

Barriers to and attitudes towards promoting husbands' involvement in maternal health in Katmandu, Nepal.

Couple-friendly reproductive health services and male partner involvement in women's reproductive health have recently garnered considerable attention. Given the sensitive nature of gender roles and relations in many cultures, understanding the context of a particular setting, potential barriers, and attitudes towards a new intervention are necessary first steps in designing services that include men. In preparation for a male involvement in antenatal care intervention, this qualitative study specifically aims to: (a) understand the barriers to male involvement in maternal health and (b) explore men's, women's, and providers' attitudes towards the promotion of male involvement in antenatal care and maternal health. In-depth interviews were conducted with fourteen couples and eight maternal health care providers at a public maternity hospital in Katmandu, Nepal. Additionally, seventeen couples participated in focus group discussions. The most prominent barriers to male involvement in maternal health included low levels of knowledge, social stigma, shyness/embarrassment and job responsibilities. Though providers also foresaw some obstacles, primarily in the forms of hospital policy, manpower and space problems, providers unanimously felt the option of couples-friendly maternal health services would enhance the quality of care and understanding of health information given to pregnant women, echoing attitudes expressed by most pregnant women and their husbands. Accordingly, a major shift in hospital policy was seen as an important first step in introducing couple-friendly antenatal or delivery services. The predominantly favorable attitudes of pregnant women, husbands, and providers towards encouraging greater male involvement in maternal health in this study imply that the introduction of an option for such services would be both feasible and well accepted.

Adult↗
PubMed2003

Comprehensive health care for women in Georgia.

In summary, comprehensive health care for women begins first with a paradigm shift that acknowledges women's health is more than reproductive health. Second, it requires viewing women's health issues from an across the lifespan perspective. This perspective includes addressing women's health beginning with the formative years, through reproductive health and sexuality to the frail elderly. The OWH has launched a statewide effort, with input from the leadership of Georgia, including an eleven-member advisory council attached to the office to develop a comprehensive women's health plan. The OWH will partner with public and private organizations, academic institutions and other government agencies to devise a course of action that addresses the health needs of all women, of all ages, including racial and ethnic backgrounds, and socioeconomic and education levels. This plan will serve as a guide for those organizations whose interest is meeting Healthy People 2010 broad objective of increasing the quality and years of healthy life for women.

Comprehensive Health Care↗
PubMed2005

Health and reproductive profiles of malaria antigen-producing transgenic goats derived by somatic cell nuclear transfer.

Nuclear transfer (NT) using transfected primary cells is an efficient approach for the generation of transgenic goats. However, reprogramming abnormalities associated with this process might result in compromised animals. We examined the health, reproductive performance, and milk production of four transgenic does derived from somatic cell NT. Goats were derived from two fetal cell lines, each transfected with a transgene expressing a different version of the MSP-1(42) malaria antigen, either glycosylated or non-glycosylated. Two female kids were produced per cell line. Health and growth of these NT animals were monitored and compared with four age-matched control does. There were no differences in birth and weaning weights between NT and control animals. The NT does were bred and produced a total of nine kids. The control does delivered five kids. The NT does expressing the glycosylated antigen lactated only briefly, probably as a result of over-expression of the MSP-1(42) protein. However, NT does expressing the non-glycosylated antigen had normal milk yields and produced the recombinant protein. These data demonstrated that the production of healthy transgenic founder goats by somatic cell NT is readily achievable and that these animals can be used successfully for the production of a candidate Malaria vaccine.

Animals↗
PubMed2006

Exogenous glucagon effects on health and reproductive performance of lactating dairy cows with mild fatty liver.

Severe fatty liver, a metabolic disease of dairy cows in early lactation, results in decreased health and reproductive performance, but can be alleviated by treatment with i.v. injections of glucagon. Mild fatty liver in cows effects on health and reproductive performance were determined by treatment with 14-day s.c. injections of glucagon at 7.5 or 15 mg/day. Multiparous Holstein cows (n=32) were grouped into Normal and Susceptible based on liver triacylglycerol concentrations (>1% liver tissue biopsy wet weight) at day 8 postpartum (day 0=day of parturition). Susceptible cows (n=24) were assigned randomly to three groups and s.c. injected with 0mg glucagon [60 ml 0.15M NaCl] [n=8] (same for Normal cows), 2.5 mg glucagon, or 5 mg glucagon every 8 h for 14 days, beginning day 8 postpartum. Mild fatty liver resulted in an increased number of days with elevated body temperature during the injection period, an increased incidence of mastitis after glucagon treatment, increased days to first estrus and insemination, increased days before conception occurred, and decreased conception rate. In cows with mild fatty liver, glucagon (15 mg/day) decreased the number of days with elevated body temperature and the incidence of mastitis after hormone treatment. From these results, we suggest that mild fatty liver is detrimental to health and reproduction of dairy cows and, furthermore, that exogenous glucagon decreases some of these detrimental effects.

Animals↗
PubMed2004

From anti-natalist to ultra-conservative: restricting reproductive choice in Peru.

This article examines Peru's population policy since the 1994 International Conference on Population and Development and assesses to what extent its policies and programmes have affected reproductive health and rights. It is drawn from data collected during ongoing monitoring of sexual and reproductive health policies and programmes in Peru since 1998 for the Center for Health and Gender Equity (CHANGE). Accomplishments since 1994 in Peru demonstrate good faith on the port of the government and foreign donors to make progress towards fulfilling the ICPD agenda by addressing key reproductive health concerns and promoting women's rights. Unfortunately, this progress has not been consistent. It has been overshadowed by two periods of anti-choice policies and interventions. The first, in 1996--97 under the Fujimori government, was a demographic approach that used numerical targets and undue pressure on women to accept sterilisation as the government's main poverty reduction strategy, which led to documented abuses. The second, in 2001--03 under the Toledo government, was a far-right approach that worked to limit access to essential services, including emergency contraception, condoms and post-abortion core. In spite of their contradictory nature, these two policy approaches have been the greatest obstacles to making long-lasting improvements to reproductive health and rights in Peru.

Female↗
PubMed2006

Effects of prepartum milking on postpartum reproduction, udder health and production performance in first-calf dairy heifers.

Postpartum production performance of dairy heifers may be enhanced by prepartum milking by alleviating the stress of the periparturient period. The objective of this study was to determine the impact of prepartum milking of dairy heifers on postpartum reproduction, udder health, milk production and other associated production characteristics. Pregnant heifers (Holstein, n=21; Jersey n=10) were assigned to either a prepartum milked (premilked, n=15) or control (n=16) group. Premilked heifers were milked twice daily starting 3 weeks prior to anticipated calving dates, and milk yield recorded at each milking. All heifers were evaluated on days 21, 14 and 7 before calving, and udder oedema scores and milk conductivity readings were recorded. Following calving, measurements were taken twice weekly to assess udder oedema, milk conductivity (indicative of udder infection), and reproductive health, which included palpation for uterine tone and uterine position, vaginal electrical impedance (VEI) and the quantification of cross-sectional area of the uterine horns (uterine difference) by transrectal ultrasonography. Uterine tone, uterine position, uterine difference, and VEI did not differ (P>0.10) with treatment. Overall, up to week six inclusive, postpartum premilked heifers had lower (P<0.01) udder oedema scores than control heifers and up to week five inclusive, had lower (P<0.01) milk conductivity readings (indicative of fewer incidences of udder infections) than control heifers. The premilked heifers of both breeds produced more milk (P<0.01) at calving and more milk overall from calving to day 60 postpartum than the control heifers. In summary, udder health and milk production were improved post calving in premilked heifers compared with controls. However, no overt differences in reproductive characteristics were observed between the premilked and control heifers.

Animals↗
PubMed2005

[Reasons why sterilized women refused reversive contraceptive methods].

OBJECTIVE: To identify the representations of contraceptive methods within a group of sterilized women, aiming at understanding the reasons why they refused those methods. METHODS: A descriptive qualitative study was carried out on 31 sterilized women, randomly selected from a list of patients attending the Family Planning Program of a university hospital. Data was collected through a semi-structured interview. Interview transcription was analyzed according to the Content Analysis method. RESULTS: Refusal to other contraceptive methods was based on representations formed from a mixture of technical information received at health service units, their previous experiences with contraceptive methods and information received in the social environment. Rejection of high efficacy methods (hormonal and IUD) was mostly based on their low innocuousness; refusal to fertility awareness methods (calendar calculation, Billings ovulation method) was due to their low efficacy; and rejection of barrier methods (condom, diaphragm) was due to a culturally patterned sexuality full of interdictions as well as to their low efficacy. CONCLUSIONS: The option for female sterilization may be indicative of the refusal to the contraceptive alternatives offered by health services. Reproductive health professionals should increase in their practice the knowledge about personal, socio-economic and cultural factors that affect women's choice of a contraceptive method that could guarantee a better control over their own reproductive life.

Adult↗
PubMed2004

Long-term reproductive endocrine health in young women with epilepsy during puberty.

OBJECTIVE: To evaluate the outcome of epilepsy and later reproductive endocrine health in girls who had epilepsy during puberty, using a population-based controlled study. METHODS: Sixty-nine patients (88%) and 51 control subjects (94%) of previously identified cohorts of 78 girls with epilepsy and 54 healthy control girls participated in this study (initial age 8 to 18.5 years, at follow-up 12.5 to 25.8 years). Thirty-five of the patients were initially taking valproate (VPA), 17 carbamazepine, and 17 oxcarbazepine as monotherapy. Most of the patients (61%) were off medication. All the subjects were examined clinically, the medical and menstrual histories were obtained, ovarian ultrasonography was examined, and serum reproductive hormone concentrations were analyzed. RESULTS: There were no significant differences in laboratory or clinical findings between the patients off medication and the control subjects. Postpubertal patients on medication had higher serum testosterone (1.9 nmol/L, SD 0.7 nmol/L) and androstenedione (18.8 nmol/L, SD 15.2 nmol/L) levels than patients off medication (1.4 nmol/L, SD 0.5 nmol/L, and 9.5 nmol/L, SD 2.6 nmol/L) or control subjects (1.4 nmol/L, SD 0.5 nmol/L, and 10.2 nmol/L, SD 3.2 nmol/L) (all comparisons p < 0.02). All patients still on VPA had elevated serum androstenedione levels. Polycystic ovary syndrome was more common in patients on medication (38%; in 63% on VPA, in 25% on other medication) than in patients off medication (6%) or in controls (11%) (p = 0.005). CONCLUSIONS: Epilepsy during pubertal maturation does not affect reproductive endocrine health in female subjects who discontinue the medication before adulthood. However, an increased prevalence of endocrine disorders is detected if the patients remain on antiepileptic drugs, especially VPA, until adulthood.

Adolescent↗
PubMed2004

Attitudes toward cervical cancer screening among Muslim women: a pilot study.

BACKGROUND: Immigrant Muslim women have low rates of health care utilization, especially preventive care such as breast exams, mammograms, and cervical cancer screening. Religious and cultural beliefs, such as the value placed on modesty and premarital virginity, contribute to reluctance to seek health care. In addition, it has been unclear whether discussions of health care behavior that involve sexuality and reproductive health would be welcomed among immigrant Muslim women. PURPOSES: (1) To examine the impact of religious and cultural values on health care behavior of Muslim women from immigrant backgrounds in the San Francisco Bay Area, particularly with regard to cervical cancer screening; (2) To determine whether these women would welcome discussing values and beliefs regarding sexuality and reproductive health. METHODS: Our key informants were five Muslim women who identified pelvic and Pap smear screening exams as major sources of anxiety for their community, and therefore major barriers to health care. Three focus groups were then convened, including 15 women ages 18-25, to discuss these issues in more detail. RESULTS: Many Muslim women from immigrant backgrounds face challenges in obtaining adequate health care due to some common barriers of language, transportation, insurance, and family pressures. Additionally, many Muslim women resist screening practices that are the standard in the US but which threaten their cultural and religious values. Equally important, many health care professionals contribute to the women's challenges by making inappropriate recommendations regarding physical exams and reproductive health. The women were enthusiastic and candid in discussing these highly sensitive and taboo topics.

Arabs↗
PubMed1998

Emergency contraception among refugees and the displaced.

In 1994, the international relief community began to recognize and address the reproductive health needs of refugees and displaced populations. A minimum initial service package of reproductive health services for refugees and the displaced, which includes emergency contraception (EC), was developed and recommended for use in refugee settings. This paper describes the experience of one international relief organization, the International Rescue Committee (IRC), in introducing EC into its worldwide reproductive health program. A recent IRC survey found that EC is available in 4 out of 14 settings where it provides reproductive health services. A case study from Tanzania demonstrates the modes of delivery, the demand for EC by women who have experienced sexual violence, and the community responses to this method of contraception. More information, education, and communication directed at refugee communities; more donor support for supplies; and institutional commitment to train staff are needed to expand refugee access to EC.

Contraceptives, Postcoital↗