Aspects Of Reproductive Health Research Articles

Sexual and reproductive health and rights and mHealth in policy and practice in South Africa

Information and Communications Technology (ICT) offers enormous opportunity and innovation to improve public health and health systems.This paper explores the intersections between mHealth and sexual and reproductive health and rights in both policy and practice. It is a qualitative study, informed by policy review and key informant interviews. Three case studies provide evidence of what is happening on the ground in relation to ICTs and reproductive health and rights. We argue that in terms of policy, there is little overlap between health rights and communication technology. In the area of practice, however, significant interventions address aspects of reproductive health. At present, the extent to which mHealth addresses the full range of reproductive justice and sexual and reproductive health and rights is limited, particularly in terms of government initiatives. The paper argues that mHealth projects tend to avoid contentious aspects of sexual health, while addressing favourable topics such as pregnancy and motherhood. The ways in which information is framed in mHealth mirrors current gaps within sexual and reproductive health and rights, where a limited and conservative lens predominates, and which may result in narrow programming and implementation of services.

Fertility Preservation Options for Cancer Patients

The number of reported new cancer cases is increasing every year. The probability of surviving cancer is high and is continually improving. The cancer treatment may induce ovarian or testicular failure by damaging ovarian follicles in females and spermatogonia in the males. Gonadal failure may affect all aspects of reproductive health, including pubertal development, hormone production, and sexual function in adult life. Therefore, the primary goal for cancer treatment is to ensure the highest possibility of cure and to maintain the reproductive health. The cancer patients should be provided with maximal chance to make an optimal decision without any significant impact and delay in cancer treatment. As a result of treatment innovations, the survival rates of young people have increased substantially; therefore, the need of fertility preservation has increased as well. The sperm cryopreservation and embryo cryopreservation have been standard methods of fertility preservation. Recently, the American Society for Reproductive Medicine has removed the experimental label from oocyte cryopreservation. However, other fertility preservation options including ovarian tissue and whole ovary cryopreservation and testicular tissue cryopreservation for pre-pubertal boys are still considered experimental. A coordinated approach by gynecologists, urologists, oncologists, pediatricians, surgeons, fertility specialists and counselors is required to make use of available fertility preservation options. Timely and complete information on the impact of cancer treatment on fertility and fertility preservation options should be presented to all patients when a cancer treatment is planned. The possibility of fertility preservation removes a huge concern and enables cancer patients to concentrate on their treatment and getting better. The purpose of this review is to present different options currently available to preserve fertility in men, women and adolescent children diagnosed with cancer and undergoing gonadotoxic therapy. All options are listed in two tables for quick reference. Most of the information is extracted from recent publications and presented in such a manner that it is valuable for cancer patients and professionals associated with fertility preservation.

Study of Knowledge and Practice of University Females Regarding Reproductive Health and Hygiene in Hail, Saudi Arabia

Objectives: Menstruation, although a natural process, is often linked with different types of misconceptions and social taboos, such as treating the menstruating girls as dirty, and not allowing them to discuss the menstruation related problems with other family members. All of this will eventually lead to adverse health outcomes. Keeping these facts in mind the present study was formulated to find out the knowledge and practice of university females in the area of reproductive health and hygiene. Materials and Methods: The study was carried out using a pretested and modified questionnaire. Leaflets explaining the objectives of the study were distributed in different departments of the university and subjects were invited to participate in the study. After getting an informed consent, those who agreed to fill the questionnaire were included in the study. Data were entered into SPSS-17.0 for the purpose of statistical analysis. Results: The present study shows mean age at menarche as 12.91±1.65 years. 62.5% of the subjects were aware of the menstrual cycle before their first menarche. Although 80% of the girls knew that maintaining personal hygiene can prevent problems and pain, only 62% followed satisfactory routines of hygiene. The overall score for knowledge regarding reproductive health and hygiene was found to be 54%. Conclusion: Results of the study concluded that menstrual hygiene, as a very important aspect of reproductive health, is often neglected and should be given utmost importance in the education curriculum, especially from the higher secondary levels. However, more research with strong evidences is further needed.

Impact of Y chromosome AZFc subdeletion shows lower risk of fertility impairment in Siddi tribal men, Western Ghats, India.

BackgroundIndia is characterized by the presence of a large number of endogamous castes, tribes and religions, having second largest concentration of tribal population in the World with differed genetic ethnicity, lifestyle and environmental habitat from those of mainstream population. Lack of data is constraint when it comes to tracking the tribal population health status, specifically reproductive health aspects by experimental approaches. The male fertility impairment depends on Y chromosome azoospermia factor c (AZFc) subdeletions, which varies highly in different geographical populations and in an Indian admixed population the frequency and effect of deletion on fertility is relatively poorly documented. Therefore, the current study has been initiated to enumerate and characterize the strength of association between Yq11 AZFc subdeletions and fertility impairment among Siddi tribal men of Western Ghats, India.MethodsHere, using predesigned performa we collected personal as well as familial information of 200 volunteered male subjects and grouped them into: (i) 104 married individuals with proven fertility, and (ii) 96 unmarried men with unknown fertility status. Quantification of reproductive hormones such as follicle stimulating hormone (FSH), leutinizing hormone (LH) and testosterone were studied. Oxidative stress markers like total antioxidant capacity (TAC) and super oxide dismutase (SOD) along with analysis of five sequence tagged site (STS) hotspot markers were employed for mapping of Y chromosome AZFc subdeletions. Statistical analyses were performed using SPSS software.ResultsHormonal analysis and estimation of oxidative stress markers showed normal values with no significant differences between two subgroups. However, the Y chromosome AZFc subdeletion mapping revealed evident results as an individual displayed absence of STS sY1191 marker indicating b2/b3 deletion, whereas rest of the subjects exhibited no deletion for all the five STS markers. While, the individual has fathered two children, at this point it is difficult to draw a causal link between the observed deletion and its effect on fertility.ConclusionThus, our current study suggests that the association between AZFc subdeletions with its effect on infertility varies highly in this study cohort compared to other Indian ethnic groups, exhibiting lower risk factor and non-association reaching insignificance among Siddi tribal men.Electronic supplementary materialThe online version of this article (doi:10.1186/s12610-014-0017-5) contains supplementary material, which is available to authorized users.

Whole Genome Sequencing as a Diagnostic Test: Challenges and Opportunities

Extraordinary technological advances and decreases in the cost of DNA sequencing have made the possibility of whole genome sequencing (WGS) as a highly accessible clinical test for numerous indications feasible. There have been many recent, successful applications of WGS in establishing the etiology of complex diseases and guiding therapeutic decision-making in neoplastic and nonneoplastic diseases and in various aspects of reproductive health. However, there are major, but not insurmountable, obstacles to the increased clinical implementation of WGS, such as hidden costs, issues surrounding sequencing and analysis, quality assurance and standardization protocols, ethical dilemmas, and difficulties with interpretation of the results. The widespread use of WGS in routine clinical practice remains a distant proposition. Prospective trials will be needed to establish if, and for whom, the benefits of WGS will outweigh the likely substantial costs associated with follow-up tests, the risks of overdiagnosis and overtreatment, and the associated emotional distress. WGS should be carefully implemented in the clinic to allow the realization of its potential to improve patient health in specific indications. To minimize harm the use of WGS for all other reasons must be carefully evaluated before clinical implementation.

Future Ethical Issues Involving Reproduction—With Examples from Star Trek

Science fiction narratives are regularly used to explore the consequences of contemporary and envisaged future scientific innovations along with the ensuing novel ethical and moral concepts. The television series Star Trek has dealt with aspects of reproductive health, often based on extrapolations from significant real-world breakthroughs in artificial reproductive technology and genetic engineering. This article assesses episodes that addressed such vexing ethical questions as choices affecting pregnancy after rape, advances in obstetrics including surrogate motherhood, and novel delivery techniques designed to protect the health of the mother and baby. However, the most significant ethical challenges may be those involving choices of deliberate genetic enhancements and/or frank physical alterations in non-life-threatening situations. The authors argue that responsible use of the popular science fiction genre, as exemplified by the various Star Trek series, cannot only provide advanced warning of problems and issues that science may eventually unleash but also suggest potential solutions to such problems.

Study of factors affecting contraceptive use among married women of reproductive Age

Background The use of contraception can prevent pregnancies related complication and helps in improving the women’s health and quality of their lives. Objective To explore reproductive characteristics among married women of reproductive age. To find out method of contraceptive use and side effects among married women of reproductive age. To uncover factors related to contraceptive use among married women of reproductive age. Methods This cross-sectional was carried out among (369) married couples of reproductive age group in ward number 5, 6 and 7 of Dhulikhel Municipality using purposive sampling. Those who fell in between the age group of (14-49 years) and willing to participate were included and pregnant women were excluded from the study. Questionnaire was used to obtain informations. Results Among 369(81.3%) of the respondents of reproductive age were using a modern contraceptive method. Regarding education 331(89.5%) of women’s and 352(95.1%) of husbands were literate and 275(91.6%) of women were found to be involved in decision making and had good inter-spousal communication that is 280(93.3%). Among the temporary method of family planning, Depo-Provera was the choice 150(54.5%) of contraceptive method. Conclusion The present study put more emphasis on increase in women’s literacy, women’s involvement in decision making and inter-spousal communication which helps to promote the effective use of contraceptive methods. As women play an important role in the decision making, women should be included in all aspects of reproductive health and family planning programs. Journal of College of Medical Sciences-Nepal, 2013, Vol-9, No-4, 24-29 DOI: http://dx.doi.org/10.3126/jcmsn.v9i4.10233

Epidemiological aspects of reproductive health in socially adapted youth in the Omsk region

In the article there are presented epidemiological data on the state of health of socially adapted youth of the Omsk region. There are given main characteristics of health with the analysis of body mass index. Performed medico sociological analysis and the explication of anamnestic and somatic determinants with considering their combined effect on the health of youth are put in the basis of a regional programme of monitoring of youth reproductive health.

Socioeconomic and Emotional Predictors of Decision Making for Timing Motherhood in Iranian Women in 2013

Background:Decision making for timing motherhood is one of the vital aspects of reproductive health. Separating sexual relationship from having a child has led to a different and unprecedented lifestyle in human history.Objectives:The objective of this study was to determine the socioeconomic and emotional factors predicting decision making for timing motherhood among Iranian women using the statistical softwares of IBM SPSS 21 and LISREL 8.8.Patients and Methods:This cross-sectional study enrolled 820 primiparous women from different hospitals across the country using multistage random sampling method in 2013. The tools of the study were enrich marital satisfaction, socioeconomic status, perceived social support, hopefulness, and life regard index. The data was analyzed using SPSS 20 and LISREL 8.8.Results:The results revealed that among direct pathways, marital age (β = 0.62) was the most effective predictor of timing motherhood. The hopefulness had an inverse association with timing motherhood through inverse effect of marital satisfaction. Moreover, marital satisfaction (β = -0.09), perceived social support (β = -0.09), and life regard index (β = 0.01) had an inverse effect on timing motherhood. Marital satisfaction had a non-causal effect of 0.024.Conclusions:Marital age, and socioeconomic status had a direct association, and hopefulness and marital satisfaction had an indirect one with Iranian women’s decision for timing motherhood. Therefore, this is the responsibility of policy-makers and healthcare providers to advise women by providing appropriate interventions and facilities.

Maternal cigarette smoking during pregnancy and reproductive health in children: a review of epidemiological studies

Maternal cigarette smoking may affect the intrauterine hormonal environment during pregnancy and this early fetal exposure may have detrimental effects on the future trajectory of reproductive health. In this review, we discuss the epidemiological literature on the association between prenatal exposure to maternal cigarette smoking and several aspects of reproductive health. The literature points towards an increased risk of the urogenital malformation cryptorchidism, but a potential protective effect on the risk of hypospadias in sons following prenatal cigarette smoking exposure. Studies on sexual maturation find a tendency towards accelerated pubertal development in exposed boys and girls. In adult life, prenatally exposed men have impaired semen quality compared with unexposed individuals, but an influence on fecundability, that is, the biological ability to reproduce, is less evident. We found no evidence to support an association between prenatal cigarette smoking exposure and testicular cancer. Among adult daughters, research is sparse and inconsistent, but exposure to cigarette smoking in utero may decrease fecundability. In conclusion, prenatal exposure to cigarette smoking may cause some long-term adverse effects on the reproductive health.

Cryopreservation of testicular tissue in pediatrics: practical and ethical issues

The exposure to cancer treatments (chemotherapy, radiotherapy, surgery) can adversely affect all aspects of reproductive health, possibly determining temporary or permanent hypogonadism of a primary or secondary form. In prepubertal male patients, the only option for preserving fertility is testicular tissue banking. Although significant progress has been made in fertility-based animal research with SSCs, this procedure is still in an early experimental stage. Can an experimental technique, which has potential benefits and possible risks, be offered to minors? What is the minor’s best interest in this situation? Is it more important to minimize the risks of morbidity and mortality or to preserve the child’s future fertility?

Defining the whole of reproductive health in adolescent and young adult cancer populations: fertility is only one piece of the puzzle

SUMMARY Quality of life is an important but distinct issue for adolescent and young adults (AYA) compared with older adults. Reproductive health is a key aspect of health-related quality of life and spans across physiological and psychological domains. While fertility issues have had more attention in the past 5 years, there are other aspects of reproductive health requiring recognition by healthcare practitioners in AYA oncology. These include attention to human papillomavirus and sexually transmitted infection risk, contraception and sexual health in relation to late effects of cancer and treatment. Alkylating agents in chemotherapy, total-body radiation or external-beam radiation in a field that includes the ovaries, testes or endocrine system may cause long-term impairment to reproductive health functioning. We examine reproductive health in relation to National Comprehensive Cancer Network and American Academy of Pediatrics guidelines for AYA cancer survivors in the USA. While fertility preservation ...

Reproductive Health and Morbidity among Women in Urban Slum of Lucknow: A Case Study

There is a growing recognition that gynaecological morbidity is much higher among the women of urban slums. Community-based studies of the prevalence and nature of reproductive health problems that can provide information to health-planners and policy-makers regarding appropriate strategies to improve women's reproductive health are much needed. Yet, information on the levels and patterns of problems related to reproductive health experienced by women in India is sparse. Therefore, against this backdrop, the present study has been conducted to know the several aspects of reproductive health among the women in an urban slum‘Sikandarnagar Basti’ of Lucknow. In the course of this anthropological study, extensive field work has been done in the year 2010– 2011. It includes both the primary as well as secondary sources of data. The sample of 100 ever-married women has been selected through simple random sampling. All the respondents have been interviewed intensively. Along with it, observation, case study method and photography have been used extensively for data collection. The study reveals that a large proportion of women in Sikandarnagar Basti are suffering from several reproductive health problems, but they experience morbidity silently, and are reluctant to seek care or to visit clinics and hospitals, as in the context of health, disease and treatment. The belief in supernatural agency was predominant in the society. Along with it, poverty, lack of education and unawareness were the hindrance in improving their health status and making the situation more critical.

Contribution of safe motherhood solidarity groups in using and accessing maternity services during a period of armed conflict

This report presents the results of a study on Reproductive Health done in North Kivu in September 2009. It was conducted by HEAL Africa, in partnership with the Provisional Division of Health, and financed by the University of Ottawa, Canada/CRDI with technical assistance from Western Cape University of South Africa. The study was conducted in the health zones of Birambizo and Kayna within the framework of the central office. The focus of the report is on one aspect of Reproductive Health—Low Risk Maternity. This study was conducted in rural areas given that Reproductive Health indicators are much weaker when compared with urban areas, according to EDS RDC, 2007 [1]. This study emphasizes the following points: General characteristics of the participants in the study, and the utilization and accessibility of maternity services in rural areas in conflict situations. The formula SPSS 12.0.1 was used to facilitate data analysis in the study. This study comes at a point in time when its relevance to HEAL Africa’s work will assist HEAL and its partners in determining the focus of interventions done in health zones in order to improve maternal and neonatal health. HEAL Africa firstly stepped into a Safe Motherhood pilot project in June 2006 for 9 months in the Masisi zone, then in 2007 in the Birambizo and Kayna health zones. In November 2007, HEAL expanded into Walikale and in October 2008, into Kirotshe, Binza, and Lubero. The intervention kit consists of reinforcing the capacity of existing health facilities, training traditional midwives who serve as a link between the community and the health structures, the provision of sanitary equipment, medical essentials and community mobilization was done through local leaders about health and reproduction, and organizing women of reproductive age in solidarity groups (SG) to generate maternity insurance. The community approach “Solidarity Groups for Maternity Insurance” constitutes the spine of HEAL Africa within the support it provides in Reproductive Health. The principal idea is to educate and train communities on how to use the MMR services that are available in their community, and to remove financial barriers to accessing health services. The 4 pillars that comprise the Safe Motherhood program are: family planning, prenatal care, safe assisted delivery and essential obstetric care. These four strategic measures are integral in assuring primary health care and equality for women. This study evaluates this approach, keeping in mind local strategies and their effects on improving the utilization and accessibility of reproductive health services.

A review of reproductive health research, guidelines and related gaps for women living with HIV

The study of pregnancy and motherhood in women living with HIV (WLWH) has concentrated on the health of the unborn baby and the prevention of mother-to-child transmission, whereas consideration of the broader aspects of women's reproductive health has been largely overlooked. The rights of WLWH with respect to their reproductive health should be exactly the same as non-HIV-positive women, however, inequalities exist due to discrimination and also because the treatment guidelines used in the care of women are often based on insufficient evidence. The purpose of this article is to review the available literature on reproductive health issues for WLWH and to identify gaps requiring further investigation. Our review indicates that further research is warranted into a number of aspects of reproductive health among WLWH. Currently, access to the relevant reproductive health resources and services, such as advice on contraception and fertility services, for WLWH is far from optimal in many developed countries and most developing countries. More data are needed on the most appropriate family planning options with the consideration of drug interactions between contraceptives and antiretroviral therapy and the risk of HIV transmission. Also, more research is needed to improve understanding of the maternal health challenges facing WLWH. Similarly, our understanding of the impact of HIV on the physical and emotional health of pregnant women and new mothers is far from complete. Answering these questions and countering these inequalities will help to ensure the reproductive health and child-bearing intentions of WLWH become an integral part of HIV medicine.

The impact of cancer treatment on reproductive health in young women

The diagnosis of cancer can precipitate a re-evaluation of life at all ages. In children, adolescents and young adults, a cancer diagnosis and its treatment poses specific challenges that can affect all aspects of reproductive health resulting in considerable physical, psychological and psychosexual burden. Improved survival means that this cohort of patients is expanding and with an improving life span, the resulting morbidity is also extended. The demands of this group of patients are often not fully integrated in the operational functions of the health service with considerable variation in care. This review discusses the common reproductive morbidities amongst survivors of childhood, adolescent and young adult cancer whilst planning, delivering and following cancer treatment. This includes the current issues on the assessment of ovarian reserve and preservation of fertility.

Social Work Student Attitudes Toward Contraception and the HPV Vaccine

The purpose of the current study was to examine social work student attitudes toward the social work profession's perspective on certain aspects of reproductive health in the United States: contraception, emergency contraception, and the Human Papillomavirus (HPV) vaccine. Students at a large, public, land grant university were surveyed to determine whether their personal attitudes were in line with the National Association of Social Workers (NASW) stance on reproductive health outlined in the NASW policy statement on family planning and reproductive health. The relationship between levels of religious activity and attitudes toward these aspects of reproductive health was also examined. Results suggest that almost all of the respondents support public funding for family planning. Furthermore, almost all students indicate willingness to refer clients for general contraception. However, results related to emergency contraception indicate that 72% of students disagree that it should be available for adolescents over the counter, even with parental consent, which is inconsistent with the NASW perspective. Sixty-four percent of students report believing that the HPV vaccine is unsafe. Further, as levels of religious activity increased, acceptance of some of these aspects of reproductive health decreased. Implications for social work practice, education, and directions for future research are discussed.

Reproductive Health as a Human Right

The human rights paradigm provides an important perspective on the relationship between reproduction and health as well as an essential tool for ensuring that reproductive health is achieved and reproductive rights are protected. Indeed, this relationship can be characterized as creating a discrete human right to reproductive health. International human rights law does not carve out an explicit right to reproductive health, but different aspects of this right can be assembled from the foundation of numerous human rights principles as applied to reproductive health. This article explores the many ways that reproductive health can be perceived as a human right. The human right to reproductive health arises in part from the complex, interwoven relationship between reproductive rights and the right to health. Reproductive health can be framed as a human right based upon its centrality to human functioning, its contribution to overall human health, its interconnectedness with numerous human rights, or its relationship with social factors involving sexuality, gender, and power. The right to reproductive health should be recognized as a distinct human right and not merely as a subcomponent of the right to health or as one of several rights included within a generalized collection of reproductive rights. While reproductive health rights do indeed exist at the intersection of discourses about reproductive rights, the right to health, and other human rights, conceptualizing reproductive health as a human right acknowledges the fundamental importance of reproductive health in achieving overall health. Likewise, reproductive health rights interact with and influence the attainment of many other human rights. Framed as a distinct human right, the right to reproductive health grants individuals a specific claim to all of the aspects of this right and obligates states to respect, protect, and fulfill this right. Recognition of a broad and nuanced understanding of the right to reproductive health within human rights frameworks would significantly bolster reproductive health outcomes and the rights of women and men to make reproductive decisions. The approach adopted in this article diverges in focus to some extent from much of the existing commentary on reproductive rights, which often centers on rights protecting reproductive decisional autonomy and gives less consideration to issues of reproductive health. By presenting a contrasting model that primarily focuses on reproductive health, this article highlights the specific human rights aspects of reproductive health, assesses the effect of reproductive health on human rights as well as the effect of human rights on reproductive health, and substantiates the claim that reproductive health is a human right.

Youth‐friendly reproductive health services in Jordan from the perspective of the youth: a descriptive qualitative study

This study aims at describing the needs for reproductive health services among Jordanian youth, identifying problems youth encounter when using reproductive health services, and identifying youths' perceptions of the characteristics of youth-friendly reproductive health services. A qualitative study using focus groups was conducted on a convenience sample of 60 young men (n = 33) and women (n = 27) (age 12-18 years) selected from the three regions of Jordan. The focus groups were audio taped, and content analysis was used to analyse the data. The results revealed that the participants' knowledge about aspects of reproductive health was limited or inadequate. The participants indicated their need for reproductive health information and quality services. The major barriers to using reproductive health services were unpleasant facilities, unprofessional conduct and ill-informed professionals. Youth expressed many ideas about how services could be improved to be more 'youth friendly'. The findings of this study can be useful to health services planners and healthcare providers to improve services and start youth-friendly reproductive health services in Jordan and to develop educational programmes that may improve healthcare professionals' knowledge and attitudes and advance their interpersonal skills for working with youth.

Reproductive health, birth control, and fertility change in Sweden, circa 1900–1940

This article deals with two aspects of reproductive health during the latter part of the Swedish fertility decline: failing health as a motive for birth control, and failing health as a possible consequence of illegal abortions. The main argument is that reproductive health was an important factor in most reproductive decisions during this period, a circumstance largely ignored by researchers of the fertility decline. Questions that are addressed include: How can aspects of reproductive health be viewed as explanatory factors of the fertility decline? How did men react to women's need to stop bearing children for health reasons? How did couples seeking abortion, sometimes for health reasons, perceive the risks associated with abortion? A source material mainly consisting of letters, written in the 1930s and sent to the Swedish Association for Sexuality Education, has been used to discern how aspects of health, contraception and abortion were experienced by ordinary men and women. The analysis shows that reproductive health became a motive for birth control, at this point in history, for at least two reasons. Firstly, the experience of childbirth had changed through institutionalization and secularization and, secondly, respectable masculinity was increasingly constructed to include sexual respect towards women. Still, when couples decided to abort, aspects of health were largely ignored. Often abortion was sought because the health risks associated with childbirth were perceived as larger than those associated with abortion. The connection between reproductive health and birth control was, therefore, of a rather complex kind.