SlideShare a Scribd company logo
1 of 29
Download to read offline
REPRODUCTIVE HEALTH

By: Adam F. Izzeldin; BPEH, MPH, PhD candidate.
Department of International Health, TMDU
Contents
Contents

Definition and components of reproductive health?
Demographic trends and fertility determinants
Family planning

Impact of reproductive patterns on child health
Impact of reproductive patterns on women health

Mechanisms to reduce morbidity and mortality.
What is reproductive health?
Within the framework of WHO's definition
of health as a state of complete
physical, mental and social well-being,
and not merely the absence of disease
or infirmity, reproductive health
addresses the reproductive processes,
functions and system at all stages of
life. Reproductive health, therefore,
implies that people are able to have a
responsible, satisfying and safe sex life
and that they have the capability to
reproduce and the freedom to decide if,
when and how often to do so.
(WHO)
Components of reproductive health
• Family-planning counseling, information,
education, communication and services;
• Education and services for prenatal care,
safe delivery, and post-natal care, especially
breast-feeding, infant and women's health
care;
• Prevention and appropriate treatment of
infertility; abortion; sexually transmitted
diseases; and reproductive tract infections
•

information, education and counselling, as
appropriate, on human sexuality,
reproductive health and responsible
parenthood.
Reproductive health links
• Reproductive health tied to policy
concerns about population growth as
well as health.
• International Conference on Population
and Development in Cairo 1994 focused
on population while two previous
international conferences emphasized on
family planning.

• In 2000 , the United Nation Millennium
declaration was adopted as a
commitment; however, goal 5 is to
improve maternal health (by reducing
maternal mortality three quarters).
Demographic trends and fertility determinants

• World population reached 1 billion just after 1800.
• But it took less 125 years to add the second billion in
1930.
• In 1960 the world passed the third billion.

• Within 40 years ahead the population doubled to be
6 billions in 2000.
• In year 2010 the world population reached 7 bilion.

• The majority of this expansion has taken place in
developing countries.
• The encouraging news is that the rate of growth is
declining since 1960.
World population growth

Source: United nation population division
Population size by continent, 1950-2100
The world population growth rate

2010
The process of fertility
Sterility

Marriage
Effective reproductive span
Birth of
woman

Marriage
dissolution

Menarche

Start of
marriage

B1

Postpartum
amenorrhea
B2

B2

Time to
conception

Resumption
of menses

B3

B last

Time to
conception
conception

Fetal loss

End of exposure
to risk

pregnancy

conception

B3

Death of
woman
Deliberate control of fertility
1. Reducing the effective
reproductive span through
postponement of marriage or
interrupted marriage or by
sterilization that ends
reproductive capacity early.
2. Using contraception, which
increases the time to
conception.
3. Abortion, which increases the
time added to birth interval by
pregnancies that do not lead to
live birth
The effect on fertility of the proximate
determinants: Bongaart’s Indices
•
The index of postpartum infecundity:
The proportion of potential fertility, TF, when the average
of postpartum period of the population of interest is
taken into account.
•
The index of abortion:
The proportion of TF, after postpartum first taken into
account.
•
The index of contraception:
The proportion of TF, after the effect of postpartum
infecundity and induced abortion taken into account.
•
The index of marriage:
The proportion of TF, after the first three factors are
considered. TFR= TF
Family planning
• The rationale is to reduce unintended fertility
because of its negative health and welfare
consequences and because it has been recognized
as a human right .
• Over the last 50 years, the dissemination of modern
ideas bout small families was adopted.
• In part, due to lack of availability , accessibility, and
effective contraceptive, the gap between observed
and desired fertility is grew, leading to in turn to an
increase to unintended fertility.
• According to WHO, in 2005 out of 211 million
pregnancies, 87 million women became pregnant
unintentionally.
Family planning methods
Region

Sterilization

Pill

IUD

Condom

Total

Female

Male

21.0

4.0

7.0

15.0

5.0

61.0

Africa

2.0

0.1

7.0

5.0

1.0

26.0

Asia

25.0

4.0

5.0

18.0

4.0

64.0

Latin America

31.0

2.0

13.0

8.0

4.0

70.0

Oceania

12.0

9.0

21.0

2.0

9.0

59.0

Japan

3.0

0.6

0.8

1.5

43.0

56.0

Europe

4.0

2.0

16.0

15.0

10.0

67.0

Northern America

23.0

14.0

15.0

1.0

13.0

76.0

New Zealand

14.0

19.3

20.5

3.3

11.0

74.0

World
Low and middle income countries

Industrialized region
Barriers for family planning
• The economic cost of access
to services, including
transportation and supplies.
• The social cost, including
traditional constrains, and
women movement.
• Psychic cost of contraceptive
use in a society that offer little
support for small family.
• The health cost of side effects,
whiter subjective or objective,
from contraceptive use.
Consequences of unintended pregnancy
• Abortion: represents 20%
of all pregnancies (WHO
estimates 20 million unsafe
abortion annually accounts
from 13% of maternal
deaths)
• Poor infant health with high
morbidity and mortality.
• Lower investment in human
capital (allocation f
resources for education
and health).
Organization of family planning program
• Focus on commitment to achieve
program objectives and access to
adequate resources.
• Placing the family planning program
under a national supervisory council
or by establishing a separate ministry.
• Collecting data on indicators such as
contraceptive prevalence, proportion
of unwanted births, maternal
morbidity and mortality, pregnancy
complications and their management,
and actual fertility level.
Intervention levels of family planning
Health center

community

menstrual regulation or vacuum aspiration
abortion

Information, education, and communication

Surgical contraception/ post abortion
counseling and contraception

Community-based distribution

counseling and treatment of
contraceptive side effects

Social marketing of condoms and pills

Health post
Counseling/ screening for contraception

Counseling/ referral for menstrual
regulation or abortion
Inject able contraceptive/ IUD/ counseling
and treatment of contraceptive side effects

Family
planning

District Hospital
Surgical contraception

Abortion through 20 weeks

post abortion counseling and
contraception
Strategies of Bangladesh Family planning

Diagram

Strategy 1

Improving
coverage and
quality of
services ( 5
miles clinics,
free of charge
sterilization,
home service)

Strategy 2

Awareness and
motivation (
mass media,
focused
programs)

Strategy 3

Fostering
villagebased and
household
services
(outreach)

Strategy 4

Community
development and
demand creation
(improving status of
women through
other program such
as micro-credit and
education).
Impact of reproductive patterns on
child health
Reproductive pattern

Mechanism through which child health affected

First born child

Higher frequency of death (parents less experienced in child care,
poor intrauterine growth)

Higher-order children

Cumulative maternal injuries “maternal depletion syndrome” leads to
poor intrauterine growth.

Large families

Competition for limited resources (disproportionate girls)

Child born to very young
mother

Inadequate development of reproductive system causes maternal
risks, and inexperience in prenatal care and delivery

Child born to older mother

Greater risk of birth trauma and genetic abnormality

Short interbirth intervals

Inadequate maternal recovery (depletion);similar-age siblings
competition; termination of breastfeeding; low-birth, infections

Unwantedness

Conscious or unconscious neglect; child born in stressful situation

Maternal death or illness

Early termination of breastfeeding; no maternal care; disease may
be passed to child

Contraceptive use

Hormonal contraception may interrupt braestfeeding
Maternal health
• Pregnancy is one of major health
risks for women in in low-and middleincome countries.
• Nearly 536,000 women die worldwide
each year due to pregnancy related
causes, and the vast majority (99%)
of these deaths in low- and middleincome countries.

• Although these numbers are
alarming,230 million pregnancies
and approximately 118 million births
occur annually in the world in safe
reproduction.
Confusion in definitions of maternal deaths
• Definition for Maternal deaths which defined as
deaths of woman while pregnant or up to 42
days post delivery from any cause accept
accidents. (undercount deaths up to 90 days).
• Maternal risk measurements are conceptually
distinct.
1.Maternal mortality ratio: the number of maternal
deaths to the number of pregnancies (LB)
2.Maternal mortality rate: the number of maternal
deaths divided by the number of women of
reproductive age (15 – 49 years old)
3. Life time risk: chance of dying from pregnancy
related cause.
Maternal mortality risks
• In sub-Saharan Africa and South Asia, maternal
mortality ratio of 800 maternal deaths per 100,000 live
births have been reported.
• The disparity between low- and middle-income and
high-income countries is much greater for maternal
mortality ( 20 times higher risk of maternal death per
pregnancy) than infant mortality ( 10 time s higher risk
of infant death per pregnancy).
• Life-time risk of maternal mortality vary from 1/75 in
low- and middle-income countries to 1/7,300 in highincome countries.
• Maternal mortality ratios are 50 times higher (450
death/100,000 LB in low- and middle-income countries
vs. 9 deaths/100,000 LB in high-income countries )
Total Fertility Rate, Maternal Mortality Ratios, and
Lifetime Risk of Maternal Death by region,2005. source:
Population Reference Bureau (2008)

Region

Total Fertility
Maternal
Maternal Deaths
Rate (Birth per Mortality Ratio
woman)
(Deaths per
Lifetime Risk
Death per year
100,000 LB)

World

2.6

400

1 in 92

536,000

Industrialized
countries

1.7

9

1 in 7,300

960

Low- and
middle-income

2.7

450

1 in 75

533,000

Africa

4.8

820

1 in 26

276,000

Asia

2.3

330

1 in 120

241,000

Latin America
and Caribbean

2.3

130

1 in 290

15,000
Direct and indirect causes of maternal
mortality and morbidity
• Direct: related to pregnancy or
postpartum periods (hemorrhage
25%, sepsis 15%, eclampsia 12%,
complications of unsafe abortion
13%, obstructed labor and
others).
• Indirect: related to conditions
precede, but aggravated by,
pregnancy ( anemia, diabetes,
malaria, tuberculosis, cardiac
diseases, hepatitis, and
increasingly HIV) WHO,2005
Impact of reproductive patterns on
women health
Reproductive pattern

Mechanism through which maternal health is affected

Number of pregnancies

Each pregnancy carries a risk of morbidity and mortality

Higher-risk pregnancies
First-time mothers

2-4 higher risk for obstructed labor, induced hypertension, obstetric
complications due to initial adaptation

High-order pregnancies

Hemorrhage and uterine rupture and reproductive injuries

Pregnancy at very young
maternal ages

Physiological immature reproductive system and reduced timely
care seeking.

Pregnancy at old maternal
ages

Body in poor condition for pregnancy and child birth

Short interbirth intervals

Inadequate time to rebuild nutritional stores and regain energy level.

Unwanted pregnancies
ending in unsafe abortions

Increased exposure to injuries, infections, hemorrhages, and deaths

Pregnancy for women
already in poor health

Aggravated health conditions.
Mechanisms to reduce maternal
morbidity and mortality.
• Reduced exposure to pregnancy by reducing
fertility (family planning).
• Optimization of access to emergency obstetric care
(assisted virginal delivery, removal of placenta,
using vacuum extraction or aspiration, anesthesia
and cesarean section, blood transfusion, ectopic
pregnancy and safe abortion….etc).
• Improvement of general health status and treatment
of pregnancy- and childbirth-related complications
(antenatal care, postnatal care, safe motherhood,
treatment of maternal illness….etc).
Conclusion
• Improvements are needed in the quality of family
planning services, especially in the areas of
information exchange and methods choice to
reduce fertility and unwanted pregnancy.
• Maternity care needs to be significantly expanded
to , while preventive services ( including education
of both men and women in health and sexuality,
family planning, and prevention of STIs) need to be
increased.
• At societal level, programs need to be supported to
improve the status of women through education,
changes in laws, and cultures.
Thank you for listening

More Related Content

What's hot (20)

Teenage pregnancy
Teenage pregnancyTeenage pregnancy
Teenage pregnancy
 
Human sexuality
Human sexualityHuman sexuality
Human sexuality
 
Reproductive Health: Nepal
Reproductive Health: NepalReproductive Health: Nepal
Reproductive Health: Nepal
 
Sexuality and sexual health ppt
Sexuality and sexual health pptSexuality and sexual health ppt
Sexuality and sexual health ppt
 
Adolescent health
Adolescent healthAdolescent health
Adolescent health
 
Teenage Pregnancy
Teenage PregnancyTeenage Pregnancy
Teenage Pregnancy
 
Teenage pregnancy....
Teenage pregnancy....Teenage pregnancy....
Teenage pregnancy....
 
Teenage Pregnancy
Teenage PregnancyTeenage Pregnancy
Teenage Pregnancy
 
Reproductive health
Reproductive healthReproductive health
Reproductive health
 
Adolescent Reproductive and Sexual Health (ARSH)
Adolescent Reproductive and Sexual Health (ARSH)Adolescent Reproductive and Sexual Health (ARSH)
Adolescent Reproductive and Sexual Health (ARSH)
 
Sexuality education
Sexuality educationSexuality education
Sexuality education
 
STI power point presentation
STI power point presentationSTI power point presentation
STI power point presentation
 
Reproductive Health And Rights
Reproductive Health And RightsReproductive Health And Rights
Reproductive Health And Rights
 
Prenatal care
Prenatal carePrenatal care
Prenatal care
 
teenage pregnanacy
teenage pregnanacyteenage pregnanacy
teenage pregnanacy
 
1.Reproductive health
1.Reproductive health1.Reproductive health
1.Reproductive health
 
Teenage Pregnancy
Teenage PregnancyTeenage Pregnancy
Teenage Pregnancy
 
Reproductive health lifecycle approach
Reproductive health lifecycle approachReproductive health lifecycle approach
Reproductive health lifecycle approach
 
Human sexuality
Human sexualityHuman sexuality
Human sexuality
 
Abortion.ppt for 2nd msc
Abortion.ppt for 2nd mscAbortion.ppt for 2nd msc
Abortion.ppt for 2nd msc
 

Similar to Reproductive health

reproductivehealth-140109232852-phpapp02 (1).pdf
reproductivehealth-140109232852-phpapp02 (1).pdfreproductivehealth-140109232852-phpapp02 (1).pdf
reproductivehealth-140109232852-phpapp02 (1).pdfAlexDcruz5
 
Choice for women: have your say on a new plan to tackle reproductive, materna...
Choice for women: have your say on a new plan to tackle reproductive, materna...Choice for women: have your say on a new plan to tackle reproductive, materna...
Choice for women: have your say on a new plan to tackle reproductive, materna...DFID
 
Dimitra Dubrow - Maurice Blackburn Lawyers
Dimitra Dubrow - Maurice Blackburn LawyersDimitra Dubrow - Maurice Blackburn Lawyers
Dimitra Dubrow - Maurice Blackburn LawyersInforma Australia
 
REPRODUTION HEALTH3.pptx
REPRODUTION HEALTH3.pptxREPRODUTION HEALTH3.pptx
REPRODUTION HEALTH3.pptxAnwarAliMalik
 
Maternal Health Intervention Final Report
Maternal Health Intervention Final ReportMaternal Health Intervention Final Report
Maternal Health Intervention Final ReportSolveij Praxis
 
Teenage pregnancy seminar
Teenage pregnancy seminarTeenage pregnancy seminar
Teenage pregnancy seminarWan Awatif
 
Berer keynote speech copenhagen 23 may 2013
Berer keynote speech copenhagen 23 may 2013Berer keynote speech copenhagen 23 may 2013
Berer keynote speech copenhagen 23 may 2013RHMLisa
 
Annotated Bibliography On The Midwifery
Annotated Bibliography On The MidwiferyAnnotated Bibliography On The Midwifery
Annotated Bibliography On The MidwiferyNatasha Johnson
 
The Mother & Child Project: How to Prevent the Orphan Crisis
The Mother & Child Project: How to Prevent the Orphan CrisisThe Mother & Child Project: How to Prevent the Orphan Crisis
The Mother & Child Project: How to Prevent the Orphan CrisisHopeThroughHealingHands
 
INDICATORS OF MATERNAL AND CHILD HEALTH CARE.pdf
INDICATORS OF MATERNAL AND CHILD HEALTH CARE.pdfINDICATORS OF MATERNAL AND CHILD HEALTH CARE.pdf
INDICATORS OF MATERNAL AND CHILD HEALTH CARE.pdfIbirogbaDamilola
 
Maternal and child health program
Maternal and child health programMaternal and child health program
Maternal and child health programnabina paneru
 
vital statistics related to maternal health in indIA.pptx
vital statistics related to maternal health in indIA.pptxvital statistics related to maternal health in indIA.pptx
vital statistics related to maternal health in indIA.pptxAnju Kumawat
 
Reproductive rights and health
Reproductive rights and healthReproductive rights and health
Reproductive rights and healthnabiha j
 
Laso - Family planning
Laso - Family planning Laso - Family planning
Laso - Family planning Lutfi Abdallah
 
Vital statistics related to maternal health in india
Vital statistics related to maternal health in indiaVital statistics related to maternal health in india
Vital statistics related to maternal health in indiaPriyanka Gohil
 
maternal mortality and neonatal mortality.pptx
maternal mortality and neonatal mortality.pptxmaternal mortality and neonatal mortality.pptx
maternal mortality and neonatal mortality.pptxiceatashna
 
Usage of family planning practices and its effects on women health
Usage of family planning practices and its effects on women healthUsage of family planning practices and its effects on women health
Usage of family planning practices and its effects on women healthmustafa farooqi
 
AWDF Woman of Substance on Maternal Health in Ghana
AWDF Woman of Substance on Maternal Health in GhanaAWDF Woman of Substance on Maternal Health in Ghana
AWDF Woman of Substance on Maternal Health in GhanaAmos Anyimadu
 
The Rate Of Preterm Birth Essay
The Rate Of Preterm Birth EssayThe Rate Of Preterm Birth Essay
The Rate Of Preterm Birth EssayAmber Moore
 

Similar to Reproductive health (20)

reproductivehealth-140109232852-phpapp02 (1).pdf
reproductivehealth-140109232852-phpapp02 (1).pdfreproductivehealth-140109232852-phpapp02 (1).pdf
reproductivehealth-140109232852-phpapp02 (1).pdf
 
Choice for women: have your say on a new plan to tackle reproductive, materna...
Choice for women: have your say on a new plan to tackle reproductive, materna...Choice for women: have your say on a new plan to tackle reproductive, materna...
Choice for women: have your say on a new plan to tackle reproductive, materna...
 
Dimitra Dubrow - Maurice Blackburn Lawyers
Dimitra Dubrow - Maurice Blackburn LawyersDimitra Dubrow - Maurice Blackburn Lawyers
Dimitra Dubrow - Maurice Blackburn Lawyers
 
REPRODUTION HEALTH3.pptx
REPRODUTION HEALTH3.pptxREPRODUTION HEALTH3.pptx
REPRODUTION HEALTH3.pptx
 
Maternal Health Intervention Final Report
Maternal Health Intervention Final ReportMaternal Health Intervention Final Report
Maternal Health Intervention Final Report
 
Teenage pregnancy seminar
Teenage pregnancy seminarTeenage pregnancy seminar
Teenage pregnancy seminar
 
Rh presentation day 1
Rh presentation day 1Rh presentation day 1
Rh presentation day 1
 
Berer keynote speech copenhagen 23 may 2013
Berer keynote speech copenhagen 23 may 2013Berer keynote speech copenhagen 23 may 2013
Berer keynote speech copenhagen 23 may 2013
 
Annotated Bibliography On The Midwifery
Annotated Bibliography On The MidwiferyAnnotated Bibliography On The Midwifery
Annotated Bibliography On The Midwifery
 
The Mother & Child Project: How to Prevent the Orphan Crisis
The Mother & Child Project: How to Prevent the Orphan CrisisThe Mother & Child Project: How to Prevent the Orphan Crisis
The Mother & Child Project: How to Prevent the Orphan Crisis
 
INDICATORS OF MATERNAL AND CHILD HEALTH CARE.pdf
INDICATORS OF MATERNAL AND CHILD HEALTH CARE.pdfINDICATORS OF MATERNAL AND CHILD HEALTH CARE.pdf
INDICATORS OF MATERNAL AND CHILD HEALTH CARE.pdf
 
Maternal and child health program
Maternal and child health programMaternal and child health program
Maternal and child health program
 
vital statistics related to maternal health in indIA.pptx
vital statistics related to maternal health in indIA.pptxvital statistics related to maternal health in indIA.pptx
vital statistics related to maternal health in indIA.pptx
 
Reproductive rights and health
Reproductive rights and healthReproductive rights and health
Reproductive rights and health
 
Laso - Family planning
Laso - Family planning Laso - Family planning
Laso - Family planning
 
Vital statistics related to maternal health in india
Vital statistics related to maternal health in indiaVital statistics related to maternal health in india
Vital statistics related to maternal health in india
 
maternal mortality and neonatal mortality.pptx
maternal mortality and neonatal mortality.pptxmaternal mortality and neonatal mortality.pptx
maternal mortality and neonatal mortality.pptx
 
Usage of family planning practices and its effects on women health
Usage of family planning practices and its effects on women healthUsage of family planning practices and its effects on women health
Usage of family planning practices and its effects on women health
 
AWDF Woman of Substance on Maternal Health in Ghana
AWDF Woman of Substance on Maternal Health in GhanaAWDF Woman of Substance on Maternal Health in Ghana
AWDF Woman of Substance on Maternal Health in Ghana
 
The Rate Of Preterm Birth Essay
The Rate Of Preterm Birth EssayThe Rate Of Preterm Birth Essay
The Rate Of Preterm Birth Essay
 

More from University of Khartoum (9)

EWARN
EWARNEWARN
EWARN
 
Public health emergencies
Public health emergenciesPublic health emergencies
Public health emergencies
 
Urban health
Urban healthUrban health
Urban health
 
Sociology and psychology in public health
Sociology and psychology in public healthSociology and psychology in public health
Sociology and psychology in public health
 
Health service determinants
Health service determinantsHealth service determinants
Health service determinants
 
Health promotion (2)
Health promotion (2)Health promotion (2)
Health promotion (2)
 
Evavluation of large scale health programs
Evavluation of large scale  health programsEvavluation of large scale  health programs
Evavluation of large scale health programs
 
Behavioral determinant
Behavioral determinantBehavioral determinant
Behavioral determinant
 
The Republic of the Sudan
The Republic of the SudanThe Republic of the Sudan
The Republic of the Sudan
 

Recently uploaded

Mental health Team. Dr Senthil Thirusangu
Mental health Team. Dr Senthil ThirusanguMental health Team. Dr Senthil Thirusangu
Mental health Team. Dr Senthil Thirusangu Medical University
 
SGK NGẠT NƯỚC ĐHYHN RẤT LÀ HAY NHA .pdf
SGK NGẠT NƯỚC ĐHYHN RẤT LÀ HAY NHA    .pdfSGK NGẠT NƯỚC ĐHYHN RẤT LÀ HAY NHA    .pdf
SGK NGẠT NƯỚC ĐHYHN RẤT LÀ HAY NHA .pdfHongBiThi1
 
AORTIC DISSECTION and management of aortic dissection
AORTIC DISSECTION and management of aortic dissectionAORTIC DISSECTION and management of aortic dissection
AORTIC DISSECTION and management of aortic dissectiondrhanifmohdali
 
pA2 value, Schild plot and pD2 values- applications in pharmacology
pA2 value, Schild plot and pD2 values- applications in pharmacologypA2 value, Schild plot and pD2 values- applications in pharmacology
pA2 value, Schild plot and pD2 values- applications in pharmacologyDeepakDaniel9
 
Pharmacokinetic Models by Dr. Ram D. Bawankar.ppt
Pharmacokinetic Models by Dr. Ram D.  Bawankar.pptPharmacokinetic Models by Dr. Ram D.  Bawankar.ppt
Pharmacokinetic Models by Dr. Ram D. Bawankar.pptRamDBawankar1
 
AUTONOMIC NERVOUS SYSTEM organization and functions
AUTONOMIC NERVOUS SYSTEM organization and functionsAUTONOMIC NERVOUS SYSTEM organization and functions
AUTONOMIC NERVOUS SYSTEM organization and functionsMedicoseAcademics
 
Role of Soap based and synthetic or syndets bar
Role of  Soap based and synthetic or syndets barRole of  Soap based and synthetic or syndets bar
Role of Soap based and synthetic or syndets barmohitRahangdale
 
SGK ĐIỆN GIẬT ĐHYHN RẤT LÀ HAY TUYỆT VỜI.pdf
SGK ĐIỆN GIẬT ĐHYHN        RẤT LÀ HAY TUYỆT VỜI.pdfSGK ĐIỆN GIẬT ĐHYHN        RẤT LÀ HAY TUYỆT VỜI.pdf
SGK ĐIỆN GIẬT ĐHYHN RẤT LÀ HAY TUYỆT VỜI.pdfHongBiThi1
 
Basic structure of hair and hair growth cycle.pptx
Basic structure of hair and hair growth cycle.pptxBasic structure of hair and hair growth cycle.pptx
Basic structure of hair and hair growth cycle.pptxkomalt2001
 
power point presentation of Clinical evaluation of strabismus
power point presentation of Clinical evaluation  of strabismuspower point presentation of Clinical evaluation  of strabismus
power point presentation of Clinical evaluation of strabismusChandrasekar Reddy
 
Bulimia nervosa ( Eating Disorders) Mental Health Nursing.
Bulimia nervosa ( Eating Disorders) Mental Health Nursing.Bulimia nervosa ( Eating Disorders) Mental Health Nursing.
Bulimia nervosa ( Eating Disorders) Mental Health Nursing.aarjukhadka22
 
High-Performance Thin-Layer Chromatography (HPTLC)
High-Performance Thin-Layer Chromatography (HPTLC)High-Performance Thin-Layer Chromatography (HPTLC)
High-Performance Thin-Layer Chromatography (HPTLC)kishan singh tomar
 
SGK RỐI LOẠN KALI MÁU CỰC KỲ QUAN TRỌNG.pdf
SGK RỐI LOẠN KALI MÁU CỰC KỲ QUAN TRỌNG.pdfSGK RỐI LOẠN KALI MÁU CỰC KỲ QUAN TRỌNG.pdf
SGK RỐI LOẠN KALI MÁU CỰC KỲ QUAN TRỌNG.pdfHongBiThi1
 
historyofpsychiatryinindia. Senthil Thirusangu
historyofpsychiatryinindia. Senthil Thirusanguhistoryofpsychiatryinindia. Senthil Thirusangu
historyofpsychiatryinindia. Senthil Thirusangu Medical University
 
Clinical Research Informatics Year-in-Review 2024
Clinical Research Informatics Year-in-Review 2024Clinical Research Informatics Year-in-Review 2024
Clinical Research Informatics Year-in-Review 2024Peter Embi
 
Trustworthiness of AI based predictions Aachen 2024
Trustworthiness of AI based predictions Aachen 2024Trustworthiness of AI based predictions Aachen 2024
Trustworthiness of AI based predictions Aachen 2024EwoutSteyerberg1
 

Recently uploaded (20)

Mental health Team. Dr Senthil Thirusangu
Mental health Team. Dr Senthil ThirusanguMental health Team. Dr Senthil Thirusangu
Mental health Team. Dr Senthil Thirusangu
 
SGK NGẠT NƯỚC ĐHYHN RẤT LÀ HAY NHA .pdf
SGK NGẠT NƯỚC ĐHYHN RẤT LÀ HAY NHA    .pdfSGK NGẠT NƯỚC ĐHYHN RẤT LÀ HAY NHA    .pdf
SGK NGẠT NƯỚC ĐHYHN RẤT LÀ HAY NHA .pdf
 
AORTIC DISSECTION and management of aortic dissection
AORTIC DISSECTION and management of aortic dissectionAORTIC DISSECTION and management of aortic dissection
AORTIC DISSECTION and management of aortic dissection
 
pA2 value, Schild plot and pD2 values- applications in pharmacology
pA2 value, Schild plot and pD2 values- applications in pharmacologypA2 value, Schild plot and pD2 values- applications in pharmacology
pA2 value, Schild plot and pD2 values- applications in pharmacology
 
Pharmacokinetic Models by Dr. Ram D. Bawankar.ppt
Pharmacokinetic Models by Dr. Ram D.  Bawankar.pptPharmacokinetic Models by Dr. Ram D.  Bawankar.ppt
Pharmacokinetic Models by Dr. Ram D. Bawankar.ppt
 
AUTONOMIC NERVOUS SYSTEM organization and functions
AUTONOMIC NERVOUS SYSTEM organization and functionsAUTONOMIC NERVOUS SYSTEM organization and functions
AUTONOMIC NERVOUS SYSTEM organization and functions
 
American College of physicians ACP high value care recommendations in rheumat...
American College of physicians ACP high value care recommendations in rheumat...American College of physicians ACP high value care recommendations in rheumat...
American College of physicians ACP high value care recommendations in rheumat...
 
Role of Soap based and synthetic or syndets bar
Role of  Soap based and synthetic or syndets barRole of  Soap based and synthetic or syndets bar
Role of Soap based and synthetic or syndets bar
 
SGK ĐIỆN GIẬT ĐHYHN RẤT LÀ HAY TUYỆT VỜI.pdf
SGK ĐIỆN GIẬT ĐHYHN        RẤT LÀ HAY TUYỆT VỜI.pdfSGK ĐIỆN GIẬT ĐHYHN        RẤT LÀ HAY TUYỆT VỜI.pdf
SGK ĐIỆN GIẬT ĐHYHN RẤT LÀ HAY TUYỆT VỜI.pdf
 
Basic structure of hair and hair growth cycle.pptx
Basic structure of hair and hair growth cycle.pptxBasic structure of hair and hair growth cycle.pptx
Basic structure of hair and hair growth cycle.pptx
 
Immune labs basics part 1 acute phase reactants ESR, CRP Ahmed Yehia Ismaeel,...
Immune labs basics part 1 acute phase reactants ESR, CRP Ahmed Yehia Ismaeel,...Immune labs basics part 1 acute phase reactants ESR, CRP Ahmed Yehia Ismaeel,...
Immune labs basics part 1 acute phase reactants ESR, CRP Ahmed Yehia Ismaeel,...
 
power point presentation of Clinical evaluation of strabismus
power point presentation of Clinical evaluation  of strabismuspower point presentation of Clinical evaluation  of strabismus
power point presentation of Clinical evaluation of strabismus
 
Bulimia nervosa ( Eating Disorders) Mental Health Nursing.
Bulimia nervosa ( Eating Disorders) Mental Health Nursing.Bulimia nervosa ( Eating Disorders) Mental Health Nursing.
Bulimia nervosa ( Eating Disorders) Mental Health Nursing.
 
High-Performance Thin-Layer Chromatography (HPTLC)
High-Performance Thin-Layer Chromatography (HPTLC)High-Performance Thin-Layer Chromatography (HPTLC)
High-Performance Thin-Layer Chromatography (HPTLC)
 
How to master Steroid (glucocorticoids) prescription, different scenarios, ca...
How to master Steroid (glucocorticoids) prescription, different scenarios, ca...How to master Steroid (glucocorticoids) prescription, different scenarios, ca...
How to master Steroid (glucocorticoids) prescription, different scenarios, ca...
 
SGK RỐI LOẠN KALI MÁU CỰC KỲ QUAN TRỌNG.pdf
SGK RỐI LOẠN KALI MÁU CỰC KỲ QUAN TRỌNG.pdfSGK RỐI LOẠN KALI MÁU CỰC KỲ QUAN TRỌNG.pdf
SGK RỐI LOẠN KALI MÁU CỰC KỲ QUAN TRỌNG.pdf
 
Rheumatoid arthritis Part 1, case based approach with application of the late...
Rheumatoid arthritis Part 1, case based approach with application of the late...Rheumatoid arthritis Part 1, case based approach with application of the late...
Rheumatoid arthritis Part 1, case based approach with application of the late...
 
historyofpsychiatryinindia. Senthil Thirusangu
historyofpsychiatryinindia. Senthil Thirusanguhistoryofpsychiatryinindia. Senthil Thirusangu
historyofpsychiatryinindia. Senthil Thirusangu
 
Clinical Research Informatics Year-in-Review 2024
Clinical Research Informatics Year-in-Review 2024Clinical Research Informatics Year-in-Review 2024
Clinical Research Informatics Year-in-Review 2024
 
Trustworthiness of AI based predictions Aachen 2024
Trustworthiness of AI based predictions Aachen 2024Trustworthiness of AI based predictions Aachen 2024
Trustworthiness of AI based predictions Aachen 2024
 

Reproductive health

  • 1. REPRODUCTIVE HEALTH By: Adam F. Izzeldin; BPEH, MPH, PhD candidate. Department of International Health, TMDU
  • 2. Contents Contents Definition and components of reproductive health? Demographic trends and fertility determinants Family planning Impact of reproductive patterns on child health Impact of reproductive patterns on women health Mechanisms to reduce morbidity and mortality.
  • 3. What is reproductive health? Within the framework of WHO's definition of health as a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity, reproductive health addresses the reproductive processes, functions and system at all stages of life. Reproductive health, therefore, implies that people are able to have a responsible, satisfying and safe sex life and that they have the capability to reproduce and the freedom to decide if, when and how often to do so. (WHO)
  • 4. Components of reproductive health • Family-planning counseling, information, education, communication and services; • Education and services for prenatal care, safe delivery, and post-natal care, especially breast-feeding, infant and women's health care; • Prevention and appropriate treatment of infertility; abortion; sexually transmitted diseases; and reproductive tract infections • information, education and counselling, as appropriate, on human sexuality, reproductive health and responsible parenthood.
  • 5. Reproductive health links • Reproductive health tied to policy concerns about population growth as well as health. • International Conference on Population and Development in Cairo 1994 focused on population while two previous international conferences emphasized on family planning. • In 2000 , the United Nation Millennium declaration was adopted as a commitment; however, goal 5 is to improve maternal health (by reducing maternal mortality three quarters).
  • 6. Demographic trends and fertility determinants • World population reached 1 billion just after 1800. • But it took less 125 years to add the second billion in 1930. • In 1960 the world passed the third billion. • Within 40 years ahead the population doubled to be 6 billions in 2000. • In year 2010 the world population reached 7 bilion. • The majority of this expansion has taken place in developing countries. • The encouraging news is that the rate of growth is declining since 1960.
  • 7. World population growth Source: United nation population division
  • 8. Population size by continent, 1950-2100
  • 9. The world population growth rate 2010
  • 10. The process of fertility Sterility Marriage Effective reproductive span Birth of woman Marriage dissolution Menarche Start of marriage B1 Postpartum amenorrhea B2 B2 Time to conception Resumption of menses B3 B last Time to conception conception Fetal loss End of exposure to risk pregnancy conception B3 Death of woman
  • 11. Deliberate control of fertility 1. Reducing the effective reproductive span through postponement of marriage or interrupted marriage or by sterilization that ends reproductive capacity early. 2. Using contraception, which increases the time to conception. 3. Abortion, which increases the time added to birth interval by pregnancies that do not lead to live birth
  • 12. The effect on fertility of the proximate determinants: Bongaart’s Indices • The index of postpartum infecundity: The proportion of potential fertility, TF, when the average of postpartum period of the population of interest is taken into account. • The index of abortion: The proportion of TF, after postpartum first taken into account. • The index of contraception: The proportion of TF, after the effect of postpartum infecundity and induced abortion taken into account. • The index of marriage: The proportion of TF, after the first three factors are considered. TFR= TF
  • 13. Family planning • The rationale is to reduce unintended fertility because of its negative health and welfare consequences and because it has been recognized as a human right . • Over the last 50 years, the dissemination of modern ideas bout small families was adopted. • In part, due to lack of availability , accessibility, and effective contraceptive, the gap between observed and desired fertility is grew, leading to in turn to an increase to unintended fertility. • According to WHO, in 2005 out of 211 million pregnancies, 87 million women became pregnant unintentionally.
  • 14. Family planning methods Region Sterilization Pill IUD Condom Total Female Male 21.0 4.0 7.0 15.0 5.0 61.0 Africa 2.0 0.1 7.0 5.0 1.0 26.0 Asia 25.0 4.0 5.0 18.0 4.0 64.0 Latin America 31.0 2.0 13.0 8.0 4.0 70.0 Oceania 12.0 9.0 21.0 2.0 9.0 59.0 Japan 3.0 0.6 0.8 1.5 43.0 56.0 Europe 4.0 2.0 16.0 15.0 10.0 67.0 Northern America 23.0 14.0 15.0 1.0 13.0 76.0 New Zealand 14.0 19.3 20.5 3.3 11.0 74.0 World Low and middle income countries Industrialized region
  • 15. Barriers for family planning • The economic cost of access to services, including transportation and supplies. • The social cost, including traditional constrains, and women movement. • Psychic cost of contraceptive use in a society that offer little support for small family. • The health cost of side effects, whiter subjective or objective, from contraceptive use.
  • 16. Consequences of unintended pregnancy • Abortion: represents 20% of all pregnancies (WHO estimates 20 million unsafe abortion annually accounts from 13% of maternal deaths) • Poor infant health with high morbidity and mortality. • Lower investment in human capital (allocation f resources for education and health).
  • 17. Organization of family planning program • Focus on commitment to achieve program objectives and access to adequate resources. • Placing the family planning program under a national supervisory council or by establishing a separate ministry. • Collecting data on indicators such as contraceptive prevalence, proportion of unwanted births, maternal morbidity and mortality, pregnancy complications and their management, and actual fertility level.
  • 18. Intervention levels of family planning Health center community menstrual regulation or vacuum aspiration abortion Information, education, and communication Surgical contraception/ post abortion counseling and contraception Community-based distribution counseling and treatment of contraceptive side effects Social marketing of condoms and pills Health post Counseling/ screening for contraception Counseling/ referral for menstrual regulation or abortion Inject able contraceptive/ IUD/ counseling and treatment of contraceptive side effects Family planning District Hospital Surgical contraception Abortion through 20 weeks post abortion counseling and contraception
  • 19. Strategies of Bangladesh Family planning Diagram Strategy 1 Improving coverage and quality of services ( 5 miles clinics, free of charge sterilization, home service) Strategy 2 Awareness and motivation ( mass media, focused programs) Strategy 3 Fostering villagebased and household services (outreach) Strategy 4 Community development and demand creation (improving status of women through other program such as micro-credit and education).
  • 20. Impact of reproductive patterns on child health Reproductive pattern Mechanism through which child health affected First born child Higher frequency of death (parents less experienced in child care, poor intrauterine growth) Higher-order children Cumulative maternal injuries “maternal depletion syndrome” leads to poor intrauterine growth. Large families Competition for limited resources (disproportionate girls) Child born to very young mother Inadequate development of reproductive system causes maternal risks, and inexperience in prenatal care and delivery Child born to older mother Greater risk of birth trauma and genetic abnormality Short interbirth intervals Inadequate maternal recovery (depletion);similar-age siblings competition; termination of breastfeeding; low-birth, infections Unwantedness Conscious or unconscious neglect; child born in stressful situation Maternal death or illness Early termination of breastfeeding; no maternal care; disease may be passed to child Contraceptive use Hormonal contraception may interrupt braestfeeding
  • 21. Maternal health • Pregnancy is one of major health risks for women in in low-and middleincome countries. • Nearly 536,000 women die worldwide each year due to pregnancy related causes, and the vast majority (99%) of these deaths in low- and middleincome countries. • Although these numbers are alarming,230 million pregnancies and approximately 118 million births occur annually in the world in safe reproduction.
  • 22. Confusion in definitions of maternal deaths • Definition for Maternal deaths which defined as deaths of woman while pregnant or up to 42 days post delivery from any cause accept accidents. (undercount deaths up to 90 days). • Maternal risk measurements are conceptually distinct. 1.Maternal mortality ratio: the number of maternal deaths to the number of pregnancies (LB) 2.Maternal mortality rate: the number of maternal deaths divided by the number of women of reproductive age (15 – 49 years old) 3. Life time risk: chance of dying from pregnancy related cause.
  • 23. Maternal mortality risks • In sub-Saharan Africa and South Asia, maternal mortality ratio of 800 maternal deaths per 100,000 live births have been reported. • The disparity between low- and middle-income and high-income countries is much greater for maternal mortality ( 20 times higher risk of maternal death per pregnancy) than infant mortality ( 10 time s higher risk of infant death per pregnancy). • Life-time risk of maternal mortality vary from 1/75 in low- and middle-income countries to 1/7,300 in highincome countries. • Maternal mortality ratios are 50 times higher (450 death/100,000 LB in low- and middle-income countries vs. 9 deaths/100,000 LB in high-income countries )
  • 24. Total Fertility Rate, Maternal Mortality Ratios, and Lifetime Risk of Maternal Death by region,2005. source: Population Reference Bureau (2008) Region Total Fertility Maternal Maternal Deaths Rate (Birth per Mortality Ratio woman) (Deaths per Lifetime Risk Death per year 100,000 LB) World 2.6 400 1 in 92 536,000 Industrialized countries 1.7 9 1 in 7,300 960 Low- and middle-income 2.7 450 1 in 75 533,000 Africa 4.8 820 1 in 26 276,000 Asia 2.3 330 1 in 120 241,000 Latin America and Caribbean 2.3 130 1 in 290 15,000
  • 25. Direct and indirect causes of maternal mortality and morbidity • Direct: related to pregnancy or postpartum periods (hemorrhage 25%, sepsis 15%, eclampsia 12%, complications of unsafe abortion 13%, obstructed labor and others). • Indirect: related to conditions precede, but aggravated by, pregnancy ( anemia, diabetes, malaria, tuberculosis, cardiac diseases, hepatitis, and increasingly HIV) WHO,2005
  • 26. Impact of reproductive patterns on women health Reproductive pattern Mechanism through which maternal health is affected Number of pregnancies Each pregnancy carries a risk of morbidity and mortality Higher-risk pregnancies First-time mothers 2-4 higher risk for obstructed labor, induced hypertension, obstetric complications due to initial adaptation High-order pregnancies Hemorrhage and uterine rupture and reproductive injuries Pregnancy at very young maternal ages Physiological immature reproductive system and reduced timely care seeking. Pregnancy at old maternal ages Body in poor condition for pregnancy and child birth Short interbirth intervals Inadequate time to rebuild nutritional stores and regain energy level. Unwanted pregnancies ending in unsafe abortions Increased exposure to injuries, infections, hemorrhages, and deaths Pregnancy for women already in poor health Aggravated health conditions.
  • 27. Mechanisms to reduce maternal morbidity and mortality. • Reduced exposure to pregnancy by reducing fertility (family planning). • Optimization of access to emergency obstetric care (assisted virginal delivery, removal of placenta, using vacuum extraction or aspiration, anesthesia and cesarean section, blood transfusion, ectopic pregnancy and safe abortion….etc). • Improvement of general health status and treatment of pregnancy- and childbirth-related complications (antenatal care, postnatal care, safe motherhood, treatment of maternal illness….etc).
  • 28. Conclusion • Improvements are needed in the quality of family planning services, especially in the areas of information exchange and methods choice to reduce fertility and unwanted pregnancy. • Maternity care needs to be significantly expanded to , while preventive services ( including education of both men and women in health and sexuality, family planning, and prevention of STIs) need to be increased. • At societal level, programs need to be supported to improve the status of women through education, changes in laws, and cultures.
  • 29. Thank you for listening

Editor's Notes

  1. Most disasters result in the inability of those affected to cope with outside assistance
  2. The mission of public health is to "fulfill society's interest in assuring conditions in which people can be healthy." The three core public health functions are:
  3. Most disasters result in the inability of those affected to cope with outside assistance
  4. There are many distinctions that can be made between public health and the clinical health professions
  5. Biological reproductive span is time during which a woman is capable of child bearing because she has the biological capacity to ovulate and to carry a pregnancy to a live birth.Social reproductive span, is the interval between the initiation and cessation of sexual activity