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PubMed2005

Sexual behaviour and contraceptive use among secondary school students in Ilesha south west Nigeria.

Data from several parts of Nigeria point to increasing sexual activity among single adolescents of both sexes with progressive decreasing age at initiation and poor contraceptive use. This paper investigates the sexual behaviour and contraceptive use among teenage secondary school students in Ilesha, southwest Nigeria. This is a cross-sectional population survey of 300 male and female secondary school students within the age group of 13-19 years. The setting is secondary school coaching classes in Ilesha, southwest Nigeria. The outcome measures include prevalence of sexual activity, age at first sexual debut, circumstances leading to first sexual debut, number of sexual partners and family planning use. The result shows that out of the 300 studied, 50% were sexually active, the predominant age at first coitus was 15-19 years, and circumstances leading to sexual debut included mutual agreement, coercion and curiosity. Predominant proportion of sexually active teenagers (86.7%) did not use contraception at the time of first coitus and most of them had more than one sexual partner. The conclusion from this study is that 50% of teenage secondary school girls in this part of Nigeria are sexually active; 68.7% whom, have multiple sexual partners, and 86.7% of them did not use contraception at sexual debut. This unsafe sexual behaviour therefore put them at a great risk of acquiring STDs including HIV infection, and unwanted pregnancy. This study therefore recommends sex education/family life education for young people to encourage them to delay sexual activity as much as possible and practice safe sex when it eventually commences. There is also the need to sensitise the young people, parents, teachers, the community and all stake holders on the magnitude of the problem and to open up dialogue that will break the social, cultural and other mysteries hindering adolescents and youth reproductive health education and services in Nigeria.

Adolescent↗
PubMed1996

Case-control study of risk of dehydrating diarrhoea in infants in vulnerable period after full weaning.

OBJECTIVES: To investigate risk factors for dehydrating diarrhoea in infants, with special interest in the weaning period. DESIGN: Case-control study. SETTING: Metropolitan area of Porto Alegre, Brazil. SUBJECTS: Cases were 192 children aged 0-23 months hospitalised with acute diarrhoea and moderate to severe dehydration. Controls were 192 children matched for age and neighbourhood who did not have diarrhoea in the previous week. MAIN OUTCOME MEASURES: Associations between dehydrating diarrhoea and child's age, type of milk consumed, time since breast feeding stopped, and breast feeding status. RESULTS: In infants aged < 12 months the risk of dehydrating diarrhoea was significantly higher in the first 9 months of life (P < 0.001), and in those aged 12-23 months the risk was again greater in younger children (12-17 months) (P = 0.03). The type of milk consumed before start of diarrhoea episode was strongly associated with dehydration independent of socioeconomic, environmental, maternal reproductive, demographic, and health services factors. Compared with infants exclusively breast fed, bottle fed infants were at higher risk (odds ratio (95% confidence interval) for cow's milk 6.0 (1.8 to 19.8), for formula milk 6.9 (1.4 to 33.3)). Compared with those still breast feeding, children who stopped in the previous two months were more likely to develop dehydrating diarrhoea (odds ratio 8.4 (2.4 to 29.6)). This risk decreased with time since breast feeding stopped. CONCLUSION: These results confirm the protective effect of breast feeding and suggest there is a vulnerable period soon after breast feeding is stopped, which may be of relevance for developing preventive strategies.

Acute Disease↗
PubMed2004

[Fathers' participation in childbirth at a public hospital: institutional difficulties and motivations of couples].

Participation by fathers in the process of childbirth, an aspect of the humanization of obstetric care, helps foster the fathers' involvement in raising their children. This participation provides psychosocial support for pregnant women during labor and delivery, sharing of the experience by the couple, and father-child bonding. The focus of this ethnographic research was the impact of this process on fathers participating in childbirth at a State hospital in Rio de Janeiro, with two stages: participant observation of labor and delivery and eleven interviews with fathers who had been present at delivery. Fathers' participation was influenced by: the motivation of mothers and fathers; social representations of delivery and fatherhood; and exclusion of fathers from reproductive health and pediatrics services. The father's participation was not valued by the attending staff as either a source of emotional support for the mother or as part of fatherhood. The following are necessary: inclusion of fathers in prenatal care, delivery, and pediatrics services; the training of staff to work with the families; social discussion of fatherhood and health services policies to ensure the presence of fathers during labor and childbirth.

Adult↗
PubMedDate not supplied

Need for dedicated focus on urban health within National Rural Health Mission.

National Rural Health Mission represents an important public health initiative to address essential health needs of the country's underserved population. For the Mission to achieve its goals, urban population needs to be included in its scope. Urban poor population constitutes nearly a third of India's urban population and is growing at three times the national population growth rate. Health status and access of reproductive and child health services of slum dwellers are poor and comparable to the rural population. Efforts to improve the conditions of urban poor necessitate strengthening national policy and fiscal mandate, augmenting and strengthening the urban health delivery system, coordinating among multiple stakeholders, involving private sector, strengthening municipal functioning and building community capacities. National Rural Health Mission should be broadened to National Public Health Mission. This paper discusses issues pertaining to health conditions of the urban poor, present status of services, challenges and suggests options for NRHM to bridge the large gap.

Health Services Accessibility↗
PubMed2006

Reproductive choice: screening policy and access to the means of reproduction.

The practice of screening potential users of reproductive services is of profound social and political significance. Access screening lacks a defensible rationale, is inconsistent with the principles of equality and self-determination, and violates individual and group human rights. Communities that strive to function in accord with those principles should not permit access to screening, even screening that purports to be a benign exercise of professional discretion. Because reproductive choice is controversial, regulation by law my be required in most jurisdictions to provide effective protection for reproductive rights. In Canada, for example, equal access can, and should be, guaranteed by federal regulations imposing strict conditions on the licenses of fertility clinics.

Access to Information↗
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↗
PubMed1998

IAMANEH and the new concept of reproductive health. International Association for Maternal and Neonatal Health.

Prof. Hubbert De Watteville, first Secretary General and founder of the International Federation of Gynecologists and Obstetricians (FIGO), created the International Association for Maternal and Neonatal Health (IAMANEH) in 1977, after realizing that the improvements in maternal and neonatal health observed in developed countries were not benefiting the so-called Third World. The purpose of IAMANEH was to stimulate local associations to take initiatives to improve the health of the women and their children. Lack of attention to women's own health has been characteristic of the emphasis on antenatal care to protect the newborn or family planning to reduce demographic growth, with little attention to the needs of women themselves. The evolution to the more comprehensive concepts of reproductive health has been slow and moved by a few visionaries in the Obstetrics and Gynecology establishment and by the women's rights movement. Currently, the concept has been accepted at world conferences, such as those of Cairo (1994) and Beijing (1995). Brazil officially incorporated an even wider concept of Comprehensive Women's Health Care, originated at the State University of Campinas and formally adopted by the Federal Government in 1984. It was placed in practice in the state of São Paulo between 1987 and 1990, showing important improvements in the quantity and quality of services provided to women.

Adolescent↗
PubMed2002

Where the boys are not: a brief overview of male preventive health.

Excess morbidity and premature mortality in US males is caused, in part, by lack of male participation in preventive health behaviors. Unlike women, who routinely access the health care system for periodic reproductive exams, men between the ages of 15 and 50 rarely seek preventive care services. A chart survey of a sample of female reproductive exams was undertaken to investigate the types of health care services these exams provide. Results indicated that a periodic female reproductive exam often encompasses many elements of a comprehensive history and physical exam, thus serving as an ideal preventive health vehicle, and is reimbursed as such by non-Medicare payers using preventive health codes. In most cases, reproductive issues were a minor portion of the female reproductive exam. It is speculated that males would also benefit from similar periodic, gender-appropriate preventive health exams. Like periodic reproductive exams for women, these "well male exams" would serve as abbreviated comprehensive history and physical exams, and would be reimbursed using the same preventive health codes. A list of age-appropriate preventive health interventions for men is suggested.

Adolescent↗
PubMedDate not supplied

Breaking the mold: expanding options for reproductive health awareness: the CARE experience.

The early years of the CARE family planning and reproductive health program were geared primarily toward modern methods of contraception and providing services. However, new and fresh opportunities to address reproductive health awareness and natural family planning are now emerging as important options. In these programs, coordination and collaboration with other sectors such as food and nutrition, children's health and natural resource management, combined with more sophisticated approaches for assessing need and reaching communities with information, has resulted in more people being reached than ever before with appropriate options and opportunities for reproductive health awareness and care. There are examples of CARE projects from India, Peru and Nepal where activities which feature working across development sectors and engaging communities to address their individual and collective RH needs are featured. Ways to disseminate information about reproductive health are being broadened to include creative combinations of interpersonal, mass and folk media', whether it be an informal one-to-one counseling session with flipcharts, a community mobilization event, a multi-media campaign, or any combination thereof. Likewise, the target audience need not always be the women of reproductive age, not should the RH messengers always be the medical and public health professionals. What is critical in all of these instances is to craft strategies based on appropriate research and need, continuously monitor progress, refine approaches as necessary, track results and evaluate the process and impact of interventions leading to behavior change. The challenge is not insignificant, but the rewards to be reaped through the improved programs are clearly worth striving for.

Awareness↗
PubMed1984

Cabbages and condoms: packaging and channels of distribution.

Contraception is only rarely a therapy for disease. Usually, contraceptives help adults implement informed choices. Therefore, wider channels of distribution and promotion are possible and necessary than in the case of curative therapies. The more channels of distribution that are available for the same method of contraception, the higher the prevalence of use. Establishing new channels of distribution can be as important as developing new methods of contraception. Family planning is an important element in public health, and active promotion enhances the health of individuals and physicians. Other health professionals need to understand the role of non-medical skills and channels of contraceptive distribution.

Contraception↗