Reproductive Health
BY
Jemal Y. (BSc, MPH/RH)
HU, CHMS, School of public health
3/3/2024 By Jemal Y. (MPH-RH) 1
General objectives of the course.
At the end of the course the student will be able to:
Define Reproductive Health(RH);
Describe historical development of RH, concepts
List & describe the major components of RH;
Discuss Justification for reproductive health
Appraise Reproductive health right
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Overview of Reproductive Health
• The Concept of reproductive health is wide and the
definition and interpretation of its concept remain varied.
Range from:
– improving individual health to solving of the
population problems
– Ensuring individual’s health right to universal Human
right.
– Contribution to individual health to nation
development
– Contribution to sustain Healthy generations.
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Definition of reproductive health
Reproductive health is defined as a state of
complete physical, mental, and social well
being and not merely the absence of disease or
infirmity, in all matters related to the
reproductive system, to its functions and
processes.
This definition is based on and modified from
the WHO definition of “health”.
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The definition is coined taking into consideration
three main points:
1.Sexual health (responsible, satisfying and safe sex
life),
2.Reproductive freedom (access to information,
methods and services) and
3.Safe motherhood (safe pregnancy, childbirth and
healthy children) are included.
Reproductive health is life-long, beginning even
before women and men attain sexual maturity and
continuing beyond a woman's child-bearing years.
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Reproductive health implies:-
People are able to have a 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.
Implicit in this notion is that :
The right of men and women to be informed and to
have access to safe, effective, affordable and
acceptable methods of family planning of their
choice.
The right of access to appropriate health-care services
that will enable women to go safely through
pregnancy and childbirth and to have a healthy infant.
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Sexual health is defined as a state of physical,
emotional, mental and social well-being in
relation to sexuality.
Sexual health requires a positive and respectful
approach to sexuality and sexual relationships,
as well as the possibility of having pleasurable
and safe sexual experiences, free of coercion,
discrimination and violence.
The purpose of sexual health is enhancement
of life, sex life and personal relations/human
relationship.
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Historical Development of Reproductive Health
The Concept of Modern reproductive health right originates during
the latter half of the 1960’s as “women’s health movement”.
Sex, contraception and abortion were the priority issues for
women’s movements, influenced the establishment and
popularization of the reproductive health/right concept.
Until the second World Population Conference (Belgrade
Conference) in 1964, it was thought as subject of demography.
The importance of women reproductive health rights was first
discussed in the first International Conference on Human Rights
(Tehran Conference) in 1968 and accepted that: “parents have a
basic right to determine freely and responsibly the number and
spacing of their children and to have the information and
means to do so.”
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Historical Cont……..
In the fourth World Population Conference in 1984
(Mexico City Conference), the rights were declared
as the rights of “all couples and individuals” instead
of “parents.”
Through the “United Nations Decade for Women”
(1976-1985), targeted improvements in women’s
status, and the third World Conference on Women
(Nairobi Conference) in 1985, recognition that
“women’s rights are human rights”.
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Historical Cont………
Before 1978 Alma-Ata Conference
– Basic health services in clinics and health centers
Primary health care declaration 1978
– MCH services started with more emphasis on child
survival
– Family planning was the main focus for mothers
Safe motherhood initiative in 1987
– Emphasis on maternal health
– Emphasis on reduction of maternal mortality
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Historical conti…..
International Conference on Population and
Development (ICPD) in 1994, Cairo
The ICPD Programme of Action (Twenty-Year Programme)
was adopted.
The ICPD declared that sexual and reproductive
health fundamental to human right recognized that
“achievement of reproductive health is a presumption
to sustainable, human-centered development and
stable population” and emphasis on:
– Emphasis on quality of services
– Emphasis on social injustice and woman's RH needs
and rights.
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Historical conti…..
Millennium development goals (2000) were adopted
in the 55th United Nations General Assembly.
Four of the eight development goals were directly
related to reproductive health
-Goal 3 (promoting gender equality and empowering
women)
-Goal 4 (reducing child mortality),
-Goal 5 (improving maternal health), and
-Goal 6 (combating HIV/AIDS, malaria, and other
diseases)
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Historical conti…..
Sustainable development goals(SDGs 2015-
2030)
Goal 3 :- ensure healthy lives and promote well-being
for all at all ages” and to address domestic and global
inequalities by 2030
reduce the global maternal mortality ratio to less than
70 per 100,000 live births
ensure universal access to sexual and reproductive
health services, including information and education
the integration of reproductive health into national
strategies and programs.
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Until 1994 ICPD, RH was thought of in terms of
population polices and programs that focused
principally on family planning aimed at slowing
population growth.
Many health planners see sexual & reproductive
health(SRH) as women's health, mostly related to
pregnancy & childbirth.
This is a rather narrow view.
We now recognize that SRH is a concern to everyone,
& that both men's health and women's health are
important for healthy reproduction, healthy children and
a healthy society.
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Trends in Ethiopia
A number of initiatives have been undertaken in
Ethiopia since the late 1960’s.
• As part of MDG, the first national reproductive health
strategy was developed in 2006 (2006 – 2015).
The three-component strategic plans were:
Maternal and newborn health
Family planning and fertility
Adolescent and youth reproductive health,
contingent upon the implementation of the HSTP.
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Components of reproductive health – From
programme of Action ,ICPD , 1994.
Family planning counseling information,
education ,communication and services
Education & services for ANC, safe & clean
delivery(skilled attendance) & post – natal
care( Promoting safe motherhood).
Management of obstetric & neonatal
complications & emergencies
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Components of RH . . . .
Prevention & appropriate treatment of sub-
fertility and infertility
Post – abortion care including prevention &
management of the consequences of abortion
Treatment of reproductive tract infections
(RTIS), STIS and other RH conditions
Information, education and counseling on
sexuality, RH and responsible parent hood
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Components of RH . . . .
Referral for family planning services and further
diagnosis & treatment for complications of pregnancy
,delivery & abortion , infertility and RTIS,
Screening for referral / management of breast cancer
and other cancers of the reproductive system
Adolescent sexual and Reproductive Health.
Active discouragement of harmful practices such as
FGC, gender based violence (GBV) & early marriage.
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Reasons and justifications for sexual and RH.
“Sexual and reproductive health is fundamental to
social and
economic development of communities and
nations, and a key component of an equitable
society.”
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Target Group of Reproductive health
The target population of a service includes for
whom the service is primarily or solely
intended.
The target group for reproductive health
includes
– Women of childbearing age (15 – 49 years old)
– Adolescents of both sexes
– Under five years old children
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Why these group are priority concern?
With out proper health care services these groups are
highly vulnerable to problems relating to sexual
intercourse, pregnancy, contraceptive side effects etc.
Illnesses and deaths from reproductive causes are
highest among poor women everywhere.
In countries where women are disproportionately poor,
illiterate and politically powerless , high prevalence of
reproductive illness and death are common.
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Why these group are priority concern…?
Maternal mortality is an adverse outcome of many
pregnancies.
Lack of comprehensive reproductive care is
the main reason for women to suffer and die.
Women in developing countries & economically
disadvantaged industrial nations suffer the highest
rates of complications from pregnancy, sexually
transmitted infections including HIV / AIDS, and
reproductive cancers in the world.
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Why these group are priority concern..?
Adolescents also lack reliable RH information
& basic knowledge to make responsible choice
regarding their reproductive behavior
Leaders, community members , and parents are
reluctant to provide education on sexuality to
young men and women for fear of promiscuity
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Why these group are priority concern..?
Adolescents are at high risk to acquire
infertility associated with STIS & unsafe
abortion.
Health services are not generally organized to
fill the need & demands of adolescents
Children’s health is a base for healthy
adolescence & childbearing ages
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Reproductive health right
1. Reproductive and sexual health throughout the
life cycle.
2. Reproductive self determination including:
right to voluntary choice in marriage;
right to determine number, timing and
spacing of ones children;
the right to have access to the information
and means needed to exercise voluntary
choice.
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Reproductive health right cont’
3. Equality and equity for men and women in all
spheres of life.
to make free and informed choices in all
spheres of life, free from discrimination
based on gender
4. Sexual and reproductive security including
freedom from sexual violence, coercion and
the right to privacy
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Reproductive Right ….
• The 1993 World Conference on Human Rights in
Vienna affirmed that women’s rights are human rights
and should not be subordinated to cultural or religious
traditions.
• The 1994 International Conference on Population and
Development in Cairo created a comprehensive
framework to realize reproductive rights and health.
• The 1995 Fourth World Conference on Women in
Beijing emphasized governments’ obligation to fulfill
the right to health by creating the conditions that
enable women to realize their right to health.
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Reproductive Right ….
• Women's reproductive rights may include some or all
of the following: the right to
legal and safe abortion;
birth control;
freedom from coerced sterilization and
contraception;
access good-quality reproductive healthcare;
education and access in order to make free and
informed reproductive choices.
receive education about sexually transmitted
infections and other aspects of sexuality,
menstrual health and protection from practices
such as female genital mutilation (FGM)
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Human right and Reproductive right
Human right Reproductive health obligations
Right to life and survival Prevent avoidable maternal deaths.
End female feticide and infanticide.
Screen for cancers that can be detected early and treated.
Ensure access to dual-protection contraceptive methods.
Right to liberty and Eliminate female genital mutilation.
security of the person Obtain informed consent for all procedures, including HIV
testing, sterilization, and abortion.
Encourage clients to make independent RH decisions.
Stop sexual trafficking.
Right to freedom from Protect and care for survivors of sexual assault and
inhuman and degrading domestic abuse and prosecute the perpetrators.
treatment Prohibit involuntary abortion and sterilization.
Eliminate rape as an instrument of war.
Right to marry and Prevent early or coerced marriages.
found a family Provide access to infertility services to women and men.
Prevent and treat reproductive tract infections that cause
infertility.
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By Jemal Y. (MPH-RH)
Human right and Reproductive right
Human right Reproductive health obligations
Right to decide the Provide access to a range of contraceptive methods.
number and spacing of Help people choose and use a family planning method.
one’s children Provide access to safe abortion services, where legal.
Right to non- Offer RH services to all groups, including adolescents,
discrimination and unmarried women, and refugees.
respect for difference Ensure that a husband’s or parent’s consent is not
required for RH services.
Offer services that meet women’s and men’s distinctive
RH needs.
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RH)
Human right and Reproductive right
Human right Reproductive health obligations
Right to receive and Make family planning information freely available.
impart information Offer sufficient information for people to make good RH
decisions.
Right to freedom of Do not limit RH services, such as emergency contraception,
thought, conscience, on religious grounds.
and religion Allow providers to refuse to offer contraceptive and
abortion services on the grounds of conscience where
referrals are possible and treatment in emergency situations
is protected.
Right to the benefits of Fund research on women’s as well as men’s health needs.
scientific progress Provide access to emergency contraception.
Provide access to antiretroviral treatment for AIDS.
Provide access to obstetric care that can prevent maternal
deaths.
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Thank you for your
attention!!
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