Reproductive Health Care Programmes Research Articles

Measles Serostatus in Mothers and Their Newborns in Antioquia, Colombia: Implications for Measles Elimination.

To describe the serostatus of measles IgG antibodies in pregnant women and newborns, placental transfer, and factors that determine being below the threshold of 150 mIU/mL, a cross-sectional study was conducted. Blood samples of 790 pregnant women at the time of delivery and 734 umbilical cord samples were analyzed from eight hospitals in the Aburrá Valley of Antioquia, Colombia. Measles IgG antibody measurement was performed with ELISA. The proportion of individuals with antibodies < 150 mIU/mL was 13.9% (95% CI: 12.2-15.8) in pregnant women and 11.1% (95% CI: 9.2-13.4) in newborns. The geometric mean of the antibody level of the pregnant women was 552 mIU/mL (95% CI: 504-605) and in the umbilical cord 662 mIU/mL (95% CI: 604-727). A positive correlation between pregnant woman and umbilical cord antibodies was found. The median ratio of measles IgG antibodies in umbilical cord/pregnant woman was 1.22 for all participants. A seroprevalence below the threshold of 150 mIU/mL was found in newborns whose mothers were born between 1983 and 1994, compared with those born before that period, when exposure to the wildtype virus was common (adjusted prevalence ratio: 3.6, 95% CI: 1.3-9.6). These findings suggest that there are gaps in measles immunity among women of childbearing age, before pregnancy. To close this immune gap and support efforts to maintain measles control, serological screening for measles antibodies should be routinely included in reproductive health and antenatal care programs to identify women without immunity who should be vaccinated before pregnancy or after delivery.

Pregnancy experience in the setting of cystic fibrosis: A systematic review and thematic synthesis.

To synthesize qualitative studies of subjective experience of pregnancy in people with cystic fibrosis. Thematic synthesis of qualitative studies. We searched PUBMED, CINAHL, EMBASE. PsicINFO and Social Sciences Citation Index for qualitative studies published in English, which reported on pregnancy in people with cystic fibrosis. Searches were carried out in March 2021, updated in June 2022. Studies that met the inclusion criteria were appraised for quality using the Critical Appraisal Skills Programme (CASP) for qualitative research. Data were extracted from the studies, analyse and synthesise using thematic synthesis approach. Thirteen studies were included in the review and 'Walking on a wire' framework was conceptualized. We found three analytical themes: (1) desire for information related to pregnancy in cystic fibrosis, (2) factors at play in decision-making related to pregnancy for people with cystic fibrosis and (3) pregnancy experience and eight descriptive themes: (1) information topics, (2) CF healthcare team/PwCF as a provider of reproductive health information, (3) information timing, (4) barriers to information delivery, (5) barriers to decision-making and stresses relating to the process of trying to conceive, (6) environmental factors, (7) coping with challenges, and (8) moving towards parenthood. For people with cystic fibrosis, pregnancy is a complex pathway: the amount of knowledge about cystic fibrosis and sexual and reproductive health, barriers to pregnancy and environmental factors provides the background to decision-making. Moreover, coping with pregnancy is a challenging experience, where they have to mediate between the physical and emotional implications of planning a pregnancy and the limitations imposed by the chronic health conditions. Understanding the psychological experiences of people with cystic fibrosis (PwCF) will improve future research and practice. Education about sexual and reproductive health and psychosocial care programmes are necessary to help PwCF deal with the challenges related to pregnancy. Hospitals should enhance the development of specific programmes to promote the well-being of individuals with CF who are planning a pregnancy.

The Association Between Unintended Births and Poor Child Development in India: Evidence from a Longitudinal Study.

Evidence on the association between unintended births and poor child development in developing countries is limited. We used data from three waves of the Young Lives study on childhood poverty conducted in Andhra Pradesh in 2002, 2006-07, and 2009 to examine the association between unintended births and poor child development in India. Multivariable linear regression models were used to examine the association between unintended births and four indicators of child development-height-for-age Z-score (HAZ), Peabody Picture Vocabulary Test (PPVT) score, Mathematics Achievement Test (MAT) score, and Early Grade Reading Assessment (EGRA) test score. The Propensity Score Matching (PSM) technique was also used to analyze data. Children who were reported as unintended at birth had significantly lower HAZ, PPVT, and EGRA scores compared with those who were reported as intended. PSM results support the findings from the multivariable linear regressions. Our findings provide evidence onthe association between unintended births and poor child development in India. There may be a need to reposition family planning within India's reproductive and child health care programs. Future studies must take into account the unobserved heterogeneity that our study could not address fully.

Nature and Prevalence of Menstrual Disorders among Teenage Female Students at Zagazig University, Zagazig, Egypt

Study ObjectiveTo determine the nature and prevalence of menstrual disorders among teenage girls. DesignAn observational descriptive cross-sectional study. SettingZagazig University Students' Hospital, Zagazig, Egypt. ParticipantsA representative sample of female students who attended the university pre-enrollment medical examination. InterventionsSelf-administered questionnaire covering items on the adolescents' demographic data and menstruation characteristics. Main Outcome MeasuresInformation about menarche, body mass index, physical exercise, cycle length and regularity, duration of menses, menstrual blood loss, dysmenorrhea, and premenstrual syndrome. ResultsA total of 285 questionnaires were analyzed. Mean age at menarche was 12.3 ± 1.5 years. Oligomenorrhea was reported by 18 participants (6.3%) and 5 others (1.8%) mentioned having polymenorrhea. Hypomenorrhea was noted in 25 students (8.8%), and hypermenorrhea was reported by 12 (4.2%). Irregular periods were mentioned by 24 students (8.4%). Dysmenorrhea was reported in 188 students (66.0%). Of these, 81 (28.4%) graded their pain as mild, 69 (24.2%) as moderate, and 38 (13.3%) as severe. Premenstrual syndrome was mentioned by 160 girls (56.1%). Consulting somebody regarding their menstrual problems was reported by 36 students (12.6%). ConclusionOur results are not greatly different from those in other parts of the world. Data on nature and prevalence of menstrual disorders and their effect on young women's health status, quality of life, and social integration suggest that management of these disorders should be given more attention within the available reproductive health care programs. Further research into prevalence of and risk factors for menstrual disorders and their morbidity is warranted and anxiously awaited.

Men’s participation during pregnancy, childbirth and postpartum and

Background and aim Increasing global approach to men's participation in care and reproductive health programs, in the past 15 years, has created a need to research on men’s encouragement to take responsibility for their families’ health through Men's participation. Therefore, the aim the present study is to determine men's participation in reproductive health care programs during pregnancy, in health clinics affiliated to Shahid Behshti University of Medical Sciences. In 1388. Material & methods: This was a descriptive study on 400 cases that had at least one child under 2 years and familly file in health clinics coverage Shahid Beheshti University. Sampling was multi-stage cluster Nonrandomized and research instrument was a questionnaire Findings According to the findings of the study, the mean age of participant was (37/27±5/56). (60/2 Percent) had a child and pregnancy in (24/8 Percent) was scheduled. Generally (74/2 Percent) men demonstrated good cooperation and participation and (0/25) had relative participation (89/0Percent) men had good knowledge and (11/0 Percent) had relative knowledge. There was Significant relationship between participation and education (p<0/0001), If higher education participation was low. There was Significant relationship between participation and job involvement (p<0/004). There was highest participation (83/9 Percent) in men whose job was lndependent. Also between the term Marriage and Participation was found Significant relationship (p<0/0001). There was Significant relationship between kind of Pregnancy and participation (P<0/0001) if It was planned to increase participation. Conclusions: The results of this research imply good men , s participation during pregnancy and childbirth that showe good oppurtunity for education and counseling before pregnancy that is good oppurtunity for Training men by expert person can enhance men , s participation during pregnancy and childbirth. Keywords: men's participation, prenatal care, delivery *Corresponding Author: Sharareh Jannesari, Lecturer, Dept of Midwifery, Faculty of Nursing and Midwifery, Shahid Beheshti University of Medical Science, Tehran, Iran. E-mail :shararehjannesari@gmail.com Alipoor B Sattari F (2010). [Male participation in prenatal care]. Behvarz Faslname. 19(2)40-41.(Persian) . http://www.magiran.com/temp/mag-pdf/272013/1586-20457240-B91.pdf„ -Carter M, Speizer I (2005). Salvadoran fathers´ attendance at prenatal care, delivery and postpartum care.Revista Panamericana Salud Publica. 18 (3) 149-156 -Dellmann T (2004). The best moment of my life: A literature review of father's experience of child birth. Australian Midwifery.17 (3) 20-26. http://www.journals.elsevierhealth.com/periodicals/ausmid/article/PIIS1448827204800142/abstract -Dragonas TG (1992).Greek fathers participation in labour and care of the infant. Scandinavian Journal of Caring Science.6 (3) 151-9. http://www.ncbi.nlm.nih.gov/pubmed/1439376 -Ghandi M (2009). [Male participation in maternal health]. Women´ s mahnameh.147 I 88. (Persian). http://www.magiran.com/magtoc.asp?mgID=1095& -Gruskin S Cottingham J Hilber AM et al (2008).Using human rights to improve maternal and neonatal health: history, connections and a proposed practical approach. Bulletin of the World Health Organization. http://www.who.int/bulletin/volumes/86/8/07-050500/en /print. html (Accessed on 30/05/2010). http://www.who.int/bulletin/volumes/86/8/07-050500/en/index.html Kinanee J Ezekiel-Hart J (2009) Men as partners in maternal health: Implications for reproductive health counselling in Rivers State, Nigeria. African Journal of Psychology and Counseling Vol. 1 (3), pp. 039–044. -Orji EO Adegbenro CO Moses OO etal (2007). Men´ s involvement in safe motherhood. Journal of Turkish- German Gynecology Association.8 (3) 240 -248. -Rahman MM (2009).Factors associated with delivery assistance: Dose differentials exist between Rural and Urban areas in Bangladesh? The Internet Journal of Family Practice 7(2)38-49 -Soul Sista. Inactive (2007). Men: Effective Partners for Safe Motherhood. http://www.nigeriavillagesquare.com/forum/lounge/11259-men-effective-partners-safe-motherhood.html -World Health Organization (2007). Maternal Mortality in 2005: Estimates Developed by UNICEF and UNFPA. Geneva: World Health Organization. http://www.who.int/whosis/mme_2005.pdfw -World Health Organization (2005). The World Health Report: 2005: Make Every Mother and Child Count, World Health Organization, Geneva, 2005 World Health Organization (2002). http://www.who.int/whr/2005/02_ contents_en.pdf -World Health Organization. Programming For Male Involvement in Reproductive Health. Report of the meeting of WHO Regional Advisers in Reproductive Health WHO /PAHO Washington DC, USA, 5–7 September 2001, World Health Organization, Geneva, http://whqlibdoc.who.int/hq/2002

Social determinants of sexual health

Byline: T. Sathyanarayana Rao, Rajesh. Gopalakrishnan, Anju. Kuruvilla, K. Jacob Sexual health can be defined as 'a state of physical, emotional, mental and social well-being in relation to sexuality; it is not merely the absence of disease, dysfunction or infirmity. [sup][1] Many complex issues including sexual behavior and attitudes, societal and cultural factors, biological risk and genetic predisposition, mental and physical illness influence sexual health. The limited data from India are from nonsystematic surveys and opinion polls, which explore a limited and superficial range of issues. [sup][2],[3],[4],[5],[6],[7],[8],[9] Social, cultural, economic, psychological, and genetic factors, which affect desire, attitude, behavior and practice are rarely investigated. The silence of the Indian culture on issues related to sexuality compound many issues including help seeking related to neurotic and anxiety disorders (e.g., Dhat syndrome), the HIV epidemic, reproductive tract infections, sexual violence, contraception, abortion services and female genital mutilation. Despite the Kama sutra, Indian society is extremely conservative about sex and is ambivalent about sex education in high schools. The barriers to sexual well-being include issues related to individual empowerment and choice, access to educational and clinical services, social stigma, discrimination and sexual violence. Even professional medical education does not transfer skill and confidence related to sexual health and sexual medicine. [sup][10],[11],[12],[13] The resultant vacuum is often exploited by healers who also propagate sexual misconceptions and misinformation. The cultural ambivalence and manifest conservatism result in a lack of political will to improve sex education in schools and formulate and implement policies related to sexual health. Existing Policies, Plans and Practice The National AIDS Control Program, with its focus on educating the general population about responsible sexual behavior, safer sex and condom use has had a significant impact. The reduction in the rate of HIV transmission in the country suggests success. [sup][14] The extensive treatment provision for HIV and AIDS is also an achievement. On the other hand, the National Family Welfare and the Reproductive and Child Health Care programs have focused on antenatal care, hospital deliveries, immunization and contraception with an emphasis on postpartum sterilization. Sex education in schools has met with resistance and has had a restricted impact across the country. Although India has some policies on paper, the approach is fragmentary. In addition, the principal thrust based on health, makes it one-dimensional and much less effective. Addressing Social Determinants Countries, which have accepted the need for a national policy, approach the task from a broad base employing multisectoral perspectives. The World Health Organization (WHO) has developed a framework, identified opportunities and challenges and recognized the need for contextualization and adaptation to cultural contexts in order to help promote appropriate, affordable, and accessible sexual health programs of high quality. [sup][15],[16] The WHO has argued for a broader context to sexual health going beyond fertility and reproduction and including sexual dysfunction, disability, sexual violence and sexuality. It has grounded the framework within international human rights and affirmed a rights-based approach to sexual health. The framework has argued for social determinants and includes: (i) law, policies and human rights, (ii) education, (iii) society and culture, (iv) economics, and (v) health systems. [sup][15],[16],[17] Legal mechanisms are crucial in introducing health intervention, protecting human rights and guaranteeing promotion, protection and provision of sexual health information and services. Laws can also help prevent discrimination related to sexuality and lifestyle. …

Racial inequalities in access to women's health care in southern Brazil

The aim of this population-based cross-sectional study was to investigate access by 20 to 60 year-old women--both black and white--to early detection (pap-smear) exams for breast and cervical cancer in two towns--São Leopoldo and Pelotas--in Rio Grande do Sul State, southern Brazil. Estimates of the association between race/color and access to Pap-smear and breast exams were adjusted for income, education, economic class and age. Of the 2,030 women interviewed, 16.1% were black and 83.9%, white. Black women were significantly less likely to have had a Pap-smear and/or breast exam than white women. Racial inequalities in access to cancer early detection exams persisted after controlling for age and other socioeconomic factors. Racial differentials in access to early detection (Pap-smear) exams for breast and cervical cancers might result from racial and socioeconomic inequalities experienced by black women in access to reproductive health care services and programs.

Human trafficking in Nigeria: Implication for human immune deficiency virus and acquired immune deficiency syndrome (HIV/AIDS) pandemic

Human trafficking is largely a form of slavery. The international awareness of the crime has over the years increased. Nigeria is a country of origin, transit and destination for human trafficking. This paper attempts to articulate the potential vulnerability of the victims, appraise the link between trafficking and human immune deficiency virus/acquired immune deficiency syndrome (HIV/AIDS) pandemic, assess the potency of the Nigeria legal instruments to curb human trafficking and recommend possible solutions. Because of unemployment, victims are frequently lured with promise to get a job with fat pay. Trafficking victims are exposed to unprotected sexual intercourse with multiple partners. They are also hired for pornography and bestiality. These experiences make them vulnerable to sexually transmitted diseases (STDs), HIV/AIDS and other female reproductive health challenges. The Nigeria local laws and the international conventions and protocols, which she is signatory to, all have legal potencies to curb trafficking. Therefore fighting trafficking in Nigeria is all encompassing because it requires a need for synergy of efforts to create public awareness of the crime, address the poverty situation in the country, create employment for the youths, reinforce relevant national laws, organize counseling, rehabilitation and reintegration programme for the victims and allow them access to government subsidized services for HIV/AIDS and other female reproductive health care programmes. Key words: Nigeria, human immune deficiency virus/acquired immune deficiency syndrome, human, trafficking, pandemic.

Infertility-related reproductive health knowledge and help-seeking behaviour in African countries

Data from African countries indicate that men and women attribute infertility to traditional beliefs about health and disease as well as to biomedical causes, although appropriate knowledge of the latter is frequently lacking. Infertility is a dreaded condition and as a result help-seeking is often intense and persistent. Most of the help-seeking is undertaken by women and both traditional and modern biomedical health services are accessed. There are, however, many barriers to effective and affordable biomedical infertility care, many of which are related to poor resources and lack of infrastructure, and as a result the need for infertility treatment is often unmet. Advances in the quality of care require greater commitment to the problem of infertility in African countries, the provision of health education as an integral part of infertility management, the integration of infertility services into reproductive health care programmes and defining the role of assisted reproductive technologies in low resource settings. At the same time the importance of traditional health services in infertility management should be recognized.

Infertility and the provision of infertility medical services in developing countries

BACKGROUNDWorldwide more than 70 million couples suffer from infertility, the majority being residents of developing countries. Negative consequences of childlessness are experienced to a greater degree in developing countries when compared with Western societies. Bilateral tubal occlusion due to sexually transmitted diseases and pregnancy-related infections is the most common cause of infertility in developing countries, a condition that is potentially treatable with assisted reproductive technologies (ART). New reproductive technologies are either unavailable or very costly in developing countries. This review provides a comprehensive survey of all important papers on the issue of infertility in developing countries.METHODSMedline, PubMed, Excerpta Medica and EMBASE searches identified relevant papers published between 1978 and 2007 and the keywords used were the combinations of ‘affordable, assisted reproduction, ART, developing countries, health services, infertility, IVF, simplified methods, traditional health care'.RESULTSThe exact prevalence of infertility in developing countries is unknown due to a lack of registration and well-performed studies. On the other hand, the implementation of appropriate infertility treatment is currently not a main goal for most international non-profit organizations. Keystones in the successful implementation of infertility care in low-resource settings include simplification of diagnostic and ART procedures, minimizing the complication rate of interventions, providing training-courses for health-care workers and incorporating infertility treatment into sexual and reproductive health-care programmes.CONCLUSIONSAlthough recognizing the importance of education and prevention, we believe that for the reasons of social justice, infertility treatment in developing countries requires greater attention at National and International levels.

Cultural interpretation of menstruation in relation to adolescent girls in Nigeria

Early anthropological reportage on adolescence in developing countries was largely concentrated on research and reports relating to rites and celebrations of puberty. Present day occurrences in the Nigerian socio-cultural and global terrain have however called attention to the importance of sexual attitudes and behaviours in fostering knowledge about the adolescent girl in Nigeria. The paper notes that contemporary advocates of adolescents have largely based their intervention patterns on reproductive health care programmes which greatly undermine the subject of blood flow in the female individual especially as experienced from the subjective perspective of adolescent girls. Information derived from researching cultural information on menstruation and other forms of blood flow in adolescent girls in Nigeria can contribute extensively to existing knowledge about the female world in general and on adolescent girls in particular. This will further encourage ongoing advocacy programmes in channeling the development of adolescent girls in Nigeria towards an effective sustenance of adult life. IFE PsychologIA Vol. 13(2) 2005: 219-228

Primary reproductive health care in Tanzania

The introduction of community based reproductive health care programmes in Tanzania integrated within primary health care (PHC) programmes is discussed. These programmes should address safe motherhood, fertility awareness and sexually transmitted diseases (STDs), including AIDS. It is argued that the proposed primary reproductive health care programmes will only be sustainable if community participation is achieved, and if combined with improved woman and child health programmes. Sensitized communities, who have learned how to prioritize the problems identified and the appropriate actions to take, will have to be linked at the local level with well trained and supervised health workers, having proper equipment and supplies. A limited number of measurable indicators should give feedback on progress at any given time to both communities and health workers on mutually agreed objectives. The requirements demanded for these programmes add to the difficulties of a health service which experiences already considerable financial and other constraints. Major improvement in the financial support will be needed to raise quality and confidence in the health care system. Supplementation of domestic resources by considerable long-term external donor assistance is essential for filling the resource gap. Further, a more efficient and effective use of resources is required. This makes substantial health system reform and reallocation of public spending important, as well as consistent and coordinated support for district health systems.