Introduction to RH

Muluemebet A
DPFH,JU
July, 2023

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 Objectives of the session
At the end of the session the learner will be able
to

• describe historical development of RH

• define RH
• discuss the concept and principles of RH
• Identify the components RH care

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• Please write down you expectation of

– The course:- at least 4

–This particular session:- at least 2

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 Introduction…….

Why studying RH?

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 Introduction

• The ICPD held in Cairo 1994

has pushed the issue of RH onto the agenda
of global health priorities

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 Historical development leading to today’s
concept of RH

• The concept of RH arose in the 1980s…

• It wasn’t gained international acceptance until

the 1994, ICPD, 1995 FWCW

• ICPD was critically important because it

moved the debate from
– Demographic way of think---- popn
program
– the broader concept of SRH**
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 Historical development con’d…..

Though critics have argued that

these concepts were imposed by a small
group of Western feminists organized
around the ICPD…..

the concept is already taken root also in the

service and research sectors of both
developing and developed countries

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 Developments in the women's health and
advocacy sectors

•In the early 1980s,women's health

advocates started some of the early
models of comprehensive care,

• access to a greater range of

choices in contraceptives and other
services, including abortion

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 Developments in the women's health….

•Such models were grounded in the

understanding that RH needs are related to a
wider set of economic, social and familial
circumstances in which women live

Different organizations were established to

provide not only a wide range of health care
and counseling but also legal aid, social and
advocacy services

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 Developments in the women's health….

• Discussion on population policies

International Women and Health Meeting

in Manila, in 1990, some participants
argued that population policies were
inherently coercive and could not be
reconciled with women's rights

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 Developments in the women's health….
•Subsequent effort results the production of a
document “women’s declaration on population
policies” The document outlined basic
principles

•respect for women as responsible decision

makers in their families and in society, and

•equity, non-coercion and inclusion of women at

all levels of policy making

• male responsibility, stating that ‘men have

personal and social responsibility for their own
sexual behavior and fertility
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 Developments in the women's health….

• In January 1994, over 200 women's

health advocates from 80 countries met
in Brazil….. where population policies
were discussed from diverse perspectives

Emphasis was on empowering

women and respect for and
protection of women’s right

these debates contributed to a synthesis

view that placed RH in the broader
social and economic frameworks
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 Developments in the international
agencies

•The needed to address the full range of

women's health needs throughout their life-
cycle was promoted by progressive staff within
international agencies
A paper by Rosenfield and Maine's in
1985 ‘Where is the M in MCH?’

Criticized traditional MCH programs for their

focus on foetus and new born
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 Developments in the international
agencies……

The global Safe Motherhood conference, held in

Nairobi in 1987, helped focus attention on the
problems of maternal mortality and morbidity

• International meeting on women's health held

in Brazil in 1989
in this symposium several papers
presented and discussed e.g..
reproductive tract infections as a
serious health burden for women
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 Developments in the international
agencies……

• IPPF's ‘Vision 2000’ put forward in 1992 a

broad approach to RH that includes:
gender relations and
sexuality and promotes attention to
these issues
throughout a woman's life cycle

• Funding agencies shift their program to a

broader approach of RH
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 Developments in the research sector

• Researchers in the 1980s gave increased

attention to the social, economic and political
factors in fertility

• Population research began to investigate

how gender roles and economic forces,
among other factors, shape demographic
outcomes
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Developments in the research sector ……

 By the 1990s, the effect of the

HIV/AIDS epidemic also began to influence
research

 researchers and policy-makers

began to realize that effective prevention
required better information on what motivated
sexual behavior and attitudes and how to
change them
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 Developments in the research sector…..
These emerging academic lines of work were
also taken up by several key research
organizations and networks

• WHO’s Special Program of Research,

Development and research training in
human reproduction (HRP) in mid 1980s
defined RH to include:

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 Developments in the research sector……
• maternity care,
• infant and child health,
• prevention and control of STDs and attention
to infertility.
• also recognized the importance of social issues:
Improving RH will not be achieved
without taking into consideration the
human element.
• By the early 1990s, the concept of RH was
widespread in feminist health groups and
increasingly used in the service and research
sectors
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 Progress in the UN
• The issues surrounding RH cut across
different UN divisions and subject areas for
discussion

• The most significant UN document is the

PoA resulting from the ICPD, held in Cairo
in 1994, which forms the blueprint for RH
policy around the world

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 Other key moment in the UN policy

• 1968 – International Conference on Human Rights,

Teheran
… parents have a human right to FP
• 1974 - World Population Conference,
Bucharest
governments convinced that under development was the
cause of population growth
…. WPPA* which recommend governments to

…… “Respect and ensure, regardless of their over all

demographic goal, the right of persons to determine, in a
free, informed and responsible manner, the number and
spacing of their children.”
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 Other key moment in the UN policy…..
• 1984 - International Conference on
Population, Mexico City
Issues raised in this conference
 unmet need for FP -to increase access
CBD, social marketing
 men involvement – sharing
responsibilities with women
 FP needs of adolescent

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 Other key moment in the UN policy…..
•1994 -ICPD, Cairo
This was the landmark conference, which
shaped the global policy

It had a broader scope than previous

conferences, reflecting the links between
population and poverty.
179 countries participated
A plan of Action approved by consensus

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Paradigm shift -population issues are best
addressed through people centred
approaches rather than solely demographic
rationales.

Acknowledges connection between population

and health, particularly RH, and their
linkage with development
Government replaced the 1974 WPPA
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• Contributors for the Cairo paradigm shift
women’s movement
 International human Right conventions
(reproductive right as part of human
right)
Evolving HIV/AIDS pandemic

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• The concept of RH broadly defined

• All countries are called upon to reduce

mortality and morbidity and strive to make
PHC including RH care accessible to all
individuals of appropriate age as soon as
possible and no later than 2015”.

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 Major ICPD Goals

By 2015:
• Universal access to a full range of
comprehensive RH services including FP
• Gender equity, equality, women’s
empowerment
• Universal access to education, especially
closing gender gap in primary and
secondary school education
• Reductions in infant, child and maternal
mortality; and
• Full integration of population concerns into
development strategies and planning
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1995 Fourth World Conference on Women,
Bejing
affirmed the definition of RH and rights agreed
at the ICPD, and also called upon states to
consider reviewing laws which punished
women for having illegal abortions

 extended the definition of reproductive rights to

cover sexuality
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 2000: MDGs

• Emphasis on eradicate extreme poverty and

improve the health and welfare of the
world’s poorest people by 2015

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• Goal 1: Eradicate extreme poverty and hunger
• Goal 2: Achieve universal primary education
• Goal 3: Promote gender equality and empower
women
• Goal 4: Reduce child mortality
• Goal 5: Improve maternal health
• Goal 6: Combat HIV/AIDS, malaria and other
diseases
• Goal 7: Ensure environmental sustainability
• Goal 8: Develop a global partnership for
development

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 MDGs: relevance to health perspective

• provide a common set of priorities for

addressing poverty
• place health at the heart of the MDGs; four
of the eight are directly related to RH
• set quantifiable and ambitious targets
• call for a global partnership for development

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 RH and sustainable
development goals
• Goal 1. End poverty in all its forms everywhere
• Goal 2. End hunger, achieve food security and improved
nutrition and promote sustainable agriculture
• Goal 3. Ensure healthy lives and promote well-
being for all at all ages
• Target 3,7 by 2030 ensure universal access to SRH
care services, including for FP IEC,, and the integration of RH into
national strategies and programs

• Goal 4. Ensure inclusive and equitable quality education

and promote lifelong learning opportunities for all
• Goal 5. Achieve gender equality and empower all women
and girls
•
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 RH in Agenda 2063
• The vision of Africa expressed in Agenda 2063 is
one of an Africa whose development is people-
driven, especially relying on the potential
offered by its women and youth

• Under this vision, it is envisaged that there will be

gender equality in all spheres of life and an
engaged and empowered youth

• There are seven aspirations, 20 Goals and 39

key priority areas of interventions

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The ICPD define RH as

a state of complete physical, mental and

social well-being and not merely the
absence of disease or infirmity,

in all matters relating to the reproductive

system and to its functions and processes

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Reproductive health implies that People are
able to:

 Have a satisfying and safe sex life

 Have the capability to reproduce and the
freedom to decide if, when and how often
to do so.

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Implicit to the last condition women and men
have the right:

 To be informed about safe, effective

affordable and acceptable methods of FP of
their choice….

 Of access to appropriate health care

services….. enable women to go safely
through pregnancy and childbirth and
provide couples with the best chance of
having a healthy infant
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 Concept and principles of RH
The concept of reproductive health is
based on the equality between men and
women.

 Human health, especially women’s right

is central to RH

RH service is a means to realize

reproductive health
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 Concept and principles of RH…..

• The definition of RH is not merely about

reproduction

• It must be viewed as three interconnected

domains:-

universal rights,
women’s empowerment, and
health service provision
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 Concept and principles of RH…..

•RH is a basic human right to be fulfilled by all

governments
everyone is entitled to the rights and
freedoms set out by the Universal Declaration of
Human Rights, this includes:
the right to
 Attain the highest standard of RH
 Have contraceptive choice
 Have appropriate information and
 Make RH decisions without
discrimination, coercion or violence
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 Concept and principles of RH…..

• RH seeks to address the underlying causes of

gender inequality and inequity to promote
women’s empowerment

• ensuring males participate in decisions and

understand their responsibilities;

• eliminating all forms of discrimination against

the girl child and

• accessing universal education

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 Concept and principles of RH…..

• provision of service, includes

 acceptable, affordable and quality RH
services that addresses issues of sexual and
reproductive ill-health
 Also addressing factors that may inhibit an
individual from accessing and utilizing these
services
 providing information about the
availability of service
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 Reproductive health care

• is defined as the collection of methods,

techniques and services that contribute to
RH and well-being through preventing and
solving reproductive health problems.

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 Objectives Of RH Care
• to ensure that comprehensive and factual
information and a full range of RH services are:
accessible,
acceptable and
convenient for users;
• to enable and support responsible voluntary
decisions about child bearing and methods of
FP,
• To meet the changing RH needs over the life
cycle and to do so in ways sensitive to the
diversity of circumstances of local communities
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 Components Of RH Care

Quality FP counselling, IEC and services

ANC, safe delivery and PNC, including breast
feeding
Prevention and treatment of infertility

Prevention and Rx of complications of unsafe

abortion and safe abortion services, if not
against the law
Treatment of RTIs, STIs and other conditions
of the reproductive system
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 Components Of RH Care……

Information and counselling on human

sexuality, responsible parenthood and sexual
and reproductive health

Active discouragement of HTPs, such as FGM

and GBV

Referral for additional services related to FP,

pregnancy, delivery and abortion complications,
infertility, RTIs, STIs and HIV/AIDS, and
cancers of the reproductive system

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 Summary

• The concept of reproductive health arose in

the 1980s with a growing movement away
from population control and demographic
targets….

• The 1994, ICPD forms the blue print for RH

policy around the world.

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• Contributors for the Cairo paradigm shift
women’s movement
 International human Right
conventions
(reproductive right as part of
human right)
Evolving HIV/AIDS pandemic

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 Summary……
• The definition of RH is not merely about
reproduction.

• It must be viewed as three interconnected

domains:-

universal rights,
women’s empowerment, and
health service provision.

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 Components Of RH Care
 Quality FP
 ANC, safe delivery and PNC, including breast
feeding
 Prevention and treatment of infertility
 Prevention and Rx of cxns of unsafe abortion & safe
abortion services
 Rx of RTIs, STIs and other conditions of the
reproductive system
 IEC on human sexuality, responsible parenthood &
SRH
 Active discouragement of HTPs, such as FGM and
GBV
 Referral of complicated and unmanaged cases

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 Thank you!!!
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