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PubMedDate not supplied

[Contraceptive methods used by young women in the township of Lomé (Togo)].

Despite intensive development of reproductive health services among Togolese youth over the past ten years, contraceptive prevalence remains low, particularly among young women. To help understand the reasons for the low rate of use of reproductive health services by young women (adolescents and young adults) and to assess prevalence of their contraceptive use in Lomé. In a cross-sectional study in the five precincts of Lomé township from March 08, 1999, to April 17, 1999, approximately 500 adolescent girls and young women (aged 10-24 years) were interviewed according to a semi-structured questionnaire. The variables studied were: social and demographic characteristics; knowledge about family planning, including whether they had discussed sexual issues with their parents; conditions of contraceptive use (method used by the interviewee or her sexual partner, who made the decision, geographical and financial accessibility of the method); suggestions to improve contraceptive prevalence. Data were analysed with Epi-Info 6.3 and comparisons tested with the chi-square test (significance set at 5%). 63.6% (318 of 500) of the young women and female teenagers lived with a partner; 43.4% discussed some aspects of reproductive health with their parents, especially menstruation and STDs, including AIDS. Although 93.4% of the interviewees knew about condoms and 68.2% about the calendar (rhythm) method, few of them used these (respectively 33.6% and 31.8%). The interviewees decided about contraceptive use with their partners (37%) or alone (28%), and rarely asked their parents (1%). Contraceptives were obtained at a health facility by 3.8% of the subjects, and at the drugstore or market by 20.6%. The main reason for the low rates of use of health facilities (10.4%) and of medical contraceptive methods (11.2% of all contraceptive methods used) were: lack of means, information, and interest (in such facilities and methods), and finally, lack of sexual activity. The condom was essentially the only modern contraceptive method used. The main reason for the low rate of use of reproductive health services may be that apart from the condom, women and female teenagers rarely use modern contraceptive methods. Improving information about reproductive health, creating more "young friendly clinics", and developing peer educators might improve the contraceptive prevalence rate among young women in Togo.

Adolescent↗

PubMed2005

Gender relations and reproductive decision making in Honduras.

CONTEXT: Gender differences influence decision making about reproductive health. Most information on reproductive health decision making in Latin America has come from women's reports of men's involvement. METHODS: Data were collected in Honduras in 2001 through two national surveys that used independent samples of men aged 15-59 years and women aged 15-49. Bivariate and multivariate analyses were used to identify factors associated with male-centered decision-making attitudes and behaviors regarding family size and family planning use. RESULTS: Overall, 25% of women and 28% of men said that men alone should be responsible for at least one of these reproductive decisions, and 27% of women and 21% of men said that the man in their household made one or both decisions. For women, having no children and being in a consensual union were each associated with holding male-centered decision-making attitudes; having less than a secondary education, being of medium or low socioeconomic status and living in a rural area were each associated with male-centered decision making. Among men, having less than secondary education and being in a consensual union were each associated with male-centered decision-making attitudes and behavior. Women who had ever used or were currently using modern methods were significantly less likely to hold attitudes supporting male-centered decision-making than were those who relied on traditional methods and those who had never used a modern method. CONCLUSIONS: Programs should recognize power imbalances between genders that affect women's ability to meet their stated fertility desires. In rural areas, programs should target men, encouraging them to communicate with their wives on reproductive decisions.

Adolescent↗

PubMed1993

A reproductive hazards research agenda for the 1990s. Research Needs Working Group.

There is substantial scientific and public concern about the potential effects of occupational and environmental toxicants on reproductive health. These effects include impaired functioning of the reproductive systems of men and women as well as a broad spectrum of developmental problems expressed in offspring. Research on reproduction and development is among the most complex undertakings in biomedical research. This complexity is due in part to the intricate biology of reproduction, the multiple targets involved (male, female, and offspring), the uncertainties in extrapolating from animal models to humans, and the problems involved in accurately characterizing exposures and outcomes in epidemiologic investigations. However, given the relatively brief history of research into toxicant-induced reproductive health effects, we have made enormous strides in our knowledge over the past decade. In particular, recent advances in reproductive biology and biotechnology and in the development of biological markers of exposure, effect, and susceptibility are greatly enhancing our ability to study cause-effect relationships. In this paper, the Research Needs Working Group proposes ways to apply existing knowledge to better protect reproductive health and suggests directions for future research. Fulfilling this challenging agenda will require responsible cooperation by labor, industry, government, individual citizens, and the scientific community. Further research and collaboration are essential to both prevent adverse reproductive and developmental outcomes and to formulate a sound scientific basis for policy making.

Communication↗

PubMed1981

Teratogenic evaluation of 2-nitro-p-phenylenediamine, 4-nitro-o-phenylenediamine, and 2,5-toluenediamine sulfate in the mouse.

Pregnant outbred albino (CD-1) mice were given 2-nitro-p-phenylenediamine (2NPPD; 32-256 mg/kg/day), 4-nitro-o-phenylenediamine (4NOPD; 16-1024 mg/kg/day) or 2,5-toluenediamine sulfate (2,5TDS; 16-64 mg/kg/day) by subcutaneous injection on Days 6-15 of gestation. The mice were killed on Day 18, the general health and reproductive health of the dams evaluated, and the fetuses examined and processed in order to characterize external, visceral, and skeletal malformations. The 32 and 128 through 256 mg/kg/day dose levels of 2NPPD produced a significant (p less than 0.05) reduction in average weight gain by the dam during pregnancy. There was also a significance reduction in average fetal weight at 128 mg/kg/day and above. Although 2NPPD administration led to a significant increase in the average percentage of malformed fetuses at 160 mg/kg/day and above, these effects occurred only at dosages which produced significant maternal toxicity. Teratogenic effects were observed with 4NOPD, as administration of this dye led to a significance increase in the average percent of malformed fetuses at 256 mg/kg/day and above. A significant reduction in average weight gain by the dam during pregnancy also was observed at these dose levels, as well as significant reduction in average fetal weight. Although 2,5TDS killed 4 of 31 dams at 48 mg/kg/day, and 9 of 11 dams at 64 mg/kg/day, this compound did not cause a significant increase in the average percent of malformed fetuses. There were indications of embryotoxicity, however, as dosages of 32 mg/kg/day and above led to significant reductions in average fetal weight.

Abnormalities, Drug-Induced↗

PubMed2005

Mobilizing communities: an overview of the Community Coalition Partnership Programs for the Prevention of Teen Pregnancy.

The Community Coalition Partnership Programs for the Prevention of Teen Pregnancy (CCPP) was a seven-year (1995-2002) demonstration program funded by the Centers for Disease Control and Prevention (CDC) Division of Reproductive Health conducted in 13 U.S cities. The purpose of the CCPP was to demonstrate whether community partners could mobilize and organize community resources in support of comprehensive, effective, and sustainable programs for the prevention of initial and subsequent pregnancies. This article provides a descriptive overview of the program origins, intentions, and efforts over its planning and implementation phases, including specific program requirements, needs and assets assessments, intervention focus, CDC support for evaluation efforts, implementation challenges, and ideas for translation and dissemination. CDC hopes that the experiences gained from this effort lead to a greater understanding of how to mobilize community coalitions as an intervention to prevent teen pregnancy and address other public health needs.

Adolescent↗

PubMed1999

Symptom reporting around the menopause in Beirut, Lebanon.

OBJECTIVES: to assess the extent to which women in Beirut suffer from symptoms in the course of the menopause transition, and to measure the medical management of menopause. METHODS: a survey was carried out on a representative sample of 298 women; the questionnaire collected information on respondents' sociodemographic characteristics, life circumstances, general health, and reproductive health; it also included a symptom checklist, questions on the management of menopausal symptoms, and lifestyle questions. RESULTS: the article documents the frequencies of various symptoms associated with aging and menopause; the number of symptoms reported by respondents is negatively associated with employment, but other associations with sociodemographic variables are not significant; smoking is found to be high in the study population and is associated with the occurrence of hot flashes, but its association with other menopausal symptoms is not significant; over a third of the women seek help in dealing with the symptoms they experience, 15% use hormone replacement therapy, and 20% use calcium supplements.

Adult↗

PubMed1995

Parent and student preferences for services in a school-based clinic.

As a component of program planning for a school-based clinic in a suburban high school, a sample of 199 students and 196 parents were surveyed about preferences for health services. Parents and students were asked about health services desired and level of interest. Student overall interest in health services was less than parent interest, although both groups indicated at least a moderate level of interest. Both students and parents reported interest in availability of comprehensive services, including general health services, reproductive health services, and counseling services. The process of polling parents and students serves dual purposes of informing the population about school-based clinics, as well as gathering information to attempt to match the health services offered with needs identified.

Adolescent↗

PubMed2004

Preventing postpartum depression part I: a review of biological interventions.

OBJECTIVE: This paper critically reviews the literature to determine the current state of scientific knowledge concerning the prevention of postpartum depression (PPD) from a biological perspective. METHODS: The criteria used to evaluate the interventions were derived from the standardized methodology developed by the Canadian Task Force on Preventive Health Care. Databases searched for this review include Medline, PubMed, Cinahl, PsycINFO, Embase, ProQuest, the Cochrane Library, and the World Health Organization Reproductive Health Library. Studies selected were peer-reviewed English-language articles published between January 1, 1966, and December 31, 2003. RESULTS: Seven studies that met criteria were examined. These studies focused on evaluating the preventive effect of antidepressant medication, estrogen and progesterone therapy, thyroid therapy, docosahexanoic acid, and calcium supplementation. Although some of these interventions have been examined rigorously for depression unrelated to childbirth, methodological study limitations render intervention efficacy equivocal for PPD; thus, there is limited strong evidence to guide practice or policy recommendations. CONCLUSIONS: Despite the recent upsurge of interest in this area, many questions remain unanswered, which has several implications for research.

Adult↗

PubMed2004

Preventing postpartum depression part II: A critical review of nonbiological interventions.

OBJECTIVE: To critically review the literature to determine the current state of scientific knowledge concerning the prevention of postpartum depression (PPD) from a nonbiological perspective. METHODS: Databases searched for this review include Medline, PubMed, Cinahl, PsycINFO, Embase, ProQuest, the Cochrane Library, and the World Health Organization Reproductive Health Library. Studies selected were peer-reviewed English-language articles published between January 1, 1966, and December 31, 2003. Criteria used to evaluate the interventions were derived from the standardized methodology developed by the Canadian Task Force on Preventive Health Care. RESULTS: Twenty-nine studies that met criteria were examined. These included studies evaluating interpersonal psychotherapy, cognitive-behavioural therapy, psychological debriefing, antenatal classes, intrapartum support, supportive interactions, continuity of care, antenatal identification and notification, early postpartum follow-up, flexible postpartum care, educational strategies, and relaxation with guided imagery. CONCLUSIONS: While this review demonstrates that no specific approach can be strongly recommended for clinical practice, many explicit research implications have been highlighted. To further address PPD as a public health problem, it is critical to include ethnically and socioeconomically diverse women in research efforts examining the differences among depression symptoms, intervention response rates, and health service use.

Adult↗

PubMed1997

Urbanisation and women's health in South Africa.

For many decades the migrant labor system and the influx control legislation in South Africa exacerbated male-dominant patterns of migration typical of Africa. In recent years, however, and especially following the easing of influx control legislation in 1986, migration in South Africa has increasingly involved women. This paper reports on a study conducted in Khayelitsha, Cape Town, which explored the relationship between urbanisation and the health of women. The objectives were to relate age, migration, length of stay in urban areas, employment status, and occupation to the health, including reproductive health, of women living in Khayelitsha. Interviews with 659 women (61 households had no senior woman) revealed that women enjoyed considerable social support through their neighbours, church organisations, and women's organisations. Women who lived in the most deprived section of Khayelitsha enjoyed more support from their neighbours but reported less satisfaction with the area in which they lived. Child-care support was poor and a considerable proportion of the women were disempowered by their male partners. More than 90 percent of the women had access to antenatal care. Recent immigrants had more pregnancies, were less aware of screening for cervical cancer, less likely to have had a Pap smear, less knowledgeable about where to have a Pap smear done, and less likely to have heard AIDS. More women were aware of AIDS (86%) than Pap smears (45%). More than half of those of childbearing age used contraception, mainly intramuscular hormones (76%). A significant proportion (53%) of the women reported that they had had their first pregnancy as teenagers and younger, less educated women were more likely to have had adolescent pregnancies. Policy makers are confronted by a compelling need to redress well-known urban-rural inequalities in health care in South Africa. Policy attention must also be given to the increasing urbanisation of women and the growing health care needs in urban areas.

Adult↗

PubMedDate not supplied

[Mystic, science, and politics in the development of health systems. The experience of Chile].

The combination of inspiration, science, and politics is a cornerstone precept for the common good of humanity, towards the fulfillment of social objectives. Based on this precept, this paper reviews core experiences of the Chilean Health Sector. Health sector key events taking place during the first half of the 20th century were the creation of the National Health Service and the development of mother and child healthcare policies. After the earthquake of 1939, the future President of Chile, Doctor Salvador Allende, set up the Special Sanitation Council, to balance policies. Also, he launched the Social Security reform process, which endured financing restrictions and the animosity of physicians opposing the socialization of medical care. In 1951 the reform was approved, to extend coverage to blue collar workers and their families; separate health provision from healthcare security; emphasize preventive pediatric care in mother's health, and reproductive health. The basic tenets of healthcare reform were the right to health, solidarity, and equity, as the pillars of policy-making and healthcare programming. The question of whether the evolution of social security in Chile has been consistent with the original healthcare reform tenets is raised by the author.

Chile↗

PubMed1991

Funding of health research in India.

An overview of financing of health research in India is presented based on data for the year 1987-88, collected from nearly 298 institutions involved in health research. Only 8 per cent of the funds was derived from foreign sources. Distribution of research funds was highly skewed. Research activity seemed to have concentrated in a few specialty institutes located in the four metropolitan cities. Research activities apparently matched the national health priorities, reproductive health being the most frequently reported area of research. The study concludes that since health is primarily a service sector, its research needs are not fully appreciated. As a result, research allocation in the health sector is lower, as compared to that for many other developmental sectors. The paper highlights some of the implications of this lopsided distribution to research capacity building in the country.

Humans↗

PubMedDate not supplied

[Demographic situation in regions of Siberia].

Presents a comparative medico-demographic analysis of the population number and structure, reproduction, mortality, and mean life span at some territories of West and East Siberia in 1990-1995 and predicts these values for up to the year 2005. Main problems of demographic development of Siberian territories are outlined; these processes are to be balanced with the socioeconomic and ecological status of regions. Priority measures are proposed, including development of special programs on reproduction, health promotion, organization of medico-demographic monitoring, etc.

Demography↗

PubMed2005

Review of evidence: are endocrine-disrupting chemicals in the aquatic environment impacting fish populations?

In this paper, evidence from the current literature is presented that addresses either of two questions: 1) do EDCs in the aquatic environment have the potential to impact the reproductive health and survival of various fish species, and 2) are EDCs in the aquatic environment actually impacting the reproductive health and sustainability of indigenous populations of fish? Overall, data from laboratory experiments support the hypothesis that EDCs in the aquatic environment can impact the reproductive health of various fish species, but evidence that EDCs in the aquatic environment are actually impacting the reproductive health and sustainability of indigenous fish populations is less convincing. The scarcity of evidence linking impacts of environmental EDCs with changes in reproductive success of indigenous fish populations may reflect a critical need for a dependable method or indicator to assess reproduction of fish in situ. In addition, more studies that investigate whether fish populations routinely exposed to EDCs in situ are experiencing changes in population structure are needed. Linking endocrine disruption and reproductive impairment with an ecologically relevant impact on the sustainability of real fish populations remains, with few exceptions, an open challenge.

Animals↗

PubMedDate not supplied

Current status of reproductive behaviour in Africa.

The current annual population growth rate of 3.2% in Africa will double the population by the year 2025. The majority of this population is below 15 years of age, and Africa concurrently also has the highest incidence of infertility in the world. Sexual behaviour, which has been poorly studied in Africa, has a direct impact on reproductive health [including fertility, infertility and sexually transmitted diseases (STDs)]. The multiple cultures and religions which characterize the African continent also affect reproductive health. Factors that have a significant effect on reproductive health in Africa include greater prevalence of extramarital/commercial sexual activity, polygamy, lower prevalence of contraceptives, reliance on traditional practices, high incidence of STDs and teenage pregnancies. High risk reproductive behaviours are predominantly displayed by adolescents, and the prevalence of STDs, including HIV (human immunodeficiency virus), is very high in this group. Pregnancy-related complications are the major cause of health-related problems in 15-19 year old girls. Maternal mortality rates in most countries remain high. Literacy rates affect these behaviours. It is apparent that changing the sexual behaviour of adolescents is one way of reversing the adverse trends, such as STD transmission, unwanted pregnancy and poor general reproductive health.

Adolescent↗

PubMed1994

Comparison of Holsteins selected for high and average milk production. 2. Health and reproductive response to selection for milk.

The objective of the experiment was to evaluate direct and correlated responses of secondary (fitness) traits to selection for milk yield. Data consisted of 2768 lactation records from 1078 Holstein cows by 140 sires. Bulls with high PD for milk were mated to daughters of sires with high PD for milk, and bulls with average PD for milk were mated to cows of average genetic merit, creating two genetic lines of cattle. Production, health, and reproductive data were collected. Major health categories were mammary, reproductive, respiratory, digestive, and skin and skeletal disorders. Analyses were per lactation and per lifetime. High PD line cattle averaged 940 kg more milk per lactation than the average line and differed by 500 kg for PTA milk during January 1990. By lactations, the high line cattle averaged 3.8% higher total health costs and 11.2% higher mammary costs than their average herd mates. For most health categories, high line cattle tended to incur higher cost than did average cattle. Selection of sires for high PD milk resulted in daughters that had slightly higher health costs, but total net return was still higher for daughters of high PD bulls.

Animals↗

PubMed2003

The need for family planning and safe abortion services among women sex workers seeking STI care in Cambodia.

In Cambodia, clinics established for the prevention and management of sexually transmitted infections (STIs) in women sex workers do not address other reproductive health services. The aim of this study was to assess the need for more comprehensive sexual and reproductive health services for women sex workers in Cambodia. In January 2000, relevant documents were reviewed, interviews with key informants carried out and group interviews with women sex workers conducted. Medical records from women sex workers were also reviewed and some data collected prospectively in one government STI clinic. Interviews with the women and data from the government clinic indicated that excluding condoms, a very low proportion of women sex workers were currently using a modern contraceptive method--5% of 38 women and 1.6% of 632 women, respectively. Induced abortion was widely used but was perceived to be risky and costly. Data from a mobile team intervention and the government clinic respectively showed that 25.5% (n = 1744) and 21.9% (n = 588) of women sex workers reported at least one previous induced abortion. These findings reveal the need for accessible contraception and safe abortion services among sex workers in Cambodia, and raise the issue of the reproductive rights and reproductive health needs of women sex workers in general.

Abortion, Legal↗

PubMed1999

The intrauterine device and its dynamics.

In the past decade, attention has shifted from family planning (often made available through population programs) to reproductive health--a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity, in all matters related to the reproductive system and its function and processes. Reproductive health has three components: the ability to procreate, regulate fertility and enjoy sex; the successful outcome of pregnancy through infant and child survival and growth; and the safety of the reproductive process. According to Mitchell et al., the following are key elements in a reproductive health program: (a) Family planning services that offer complete and accurate information about all contraceptive methods and that make contraceptive services, supplies and counseling accessible. (b) Antenatal care, which research suggests lowers rates of maternal mortality. (c) Safe delivery services, so that all women deliver under some type of supervised care and so that referral systems are established to provide emergency treatment of life-threatening complications of delivery. (d) Postnatal care that contributes to a woman's ability to have a speedy and complete recovery from the stress of pregnancy and childbirth, to enjoy sexual relations without pain and to have safe pregnancies and deliveries in the future. (e) Management of the complications of abortion where safe abortions are not available. (f) Infertility services that enable women to achieve their reproductive goals; and effective screening for or control of reproductive tract infections (RTIs), because RTIs are the most common preventable cause of involuntary infertility and ectopic pregnancy, as well as of chronic pelvic pain and recurrent infection. (g) Management and treatment of systemic sexually transmitted diseases (STDs), such as HIV and hepatitis B. (h) Symptomatic treatment of urinary tract infections. (i) Detection and treatment of breast and reproductive tract cancers, such as cervical cancer. (j) Attention to and treatment of dysmenorhea, which in some cases is the first sign of other problems, such as pelvic inflammatory disease, endometriosis, fibroids, endometrial cancer and ectopic pregnancy. (k) Nutritional supplementation to meet the special needs of adolescents, pregnant or lactating women, and women older than 50 years. (1) Services for menopause and other health problems that women encounter as they grow older. (m) Services for adolescents, including family planning and STD prevention and treatment. It shall be clear that many institutions delivering reproductive health services operate significantly below their physical capacity to see clients, and that much of the equipment required for expanding reproductive health services may already be available for use in family planning and other health services. In this context, we would therefore like to discuss the dynamics of IUDs.

Contraindications↗