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Introduction to Reproductive Health

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Introduction

Reproductive health is a universal concern, but is of special importance for women particularly during the reproductive years. Although most reproductive health problems arise during the reproductive years, in old age general health continues to reflect earlier reproductive life events.

Introduction cont.

Men also have reproductive health concerns and needs though to a lesser extent Men have particular roles and responsibilities in terms of women's reproductive health because of their decision-making powers in reproductive health matters.

Definition

Reproductive health is 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 and to its functions and processes.

Historical Perspective

1974- World population conference. Mainly focuses on Family planning. 1978- Alma Ata, develop the concept of PHC, with the maternal and child health care and family planning as a component. 1984- Mexico meeting, family planning facilities made more available. 1994- Cairo Conference, ICPD.

In September 1994, International Conference on Population and Development (ICPD), held in Cairo, Egypt. The ICPD marked the beginning of the paradigm shift from the concept of Maternal and Child Health and Family Planning (MCH/FP) to Reproductive Health.

The core message of ICPD

Most significant achievement of the ICPD Conference was to place people firmly at the centre of development efforts, as protagonists in their own reproductive health & lives. The focus of population programs should be to improve the quality of life of individuals and meet their needs, rather than meeting demographic targets.

Core messages of ICPD cont.

Enhance reproductive health and promote reproductive rights rather than population policies and fertility control. Empowerment of women (including through better access to education). Involvement of women & young people in the development & implementation of programs& services Reaching out to the poor, marginalized and excluded. Men assuming greater responsibility for reproductive health.

Definition ICPD 1994
“Reproductive health is a state of complete physical , mental and social well beings in all matter related to the reproductive system and to its function and processes. Reproductive health therefore implies that 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 last condition are the right of men and women to be informed and have access to safe , effective , affordable and acceptable method of family planning of their choices and the right to access to appropriate health care services that will enable women to go safely through pregnancy and childbirth and provide couple with best chance of having healthy infant”.

Key ICPD Concepts

Reproductive Health & Reproductive Rights. Gender Equality, Equity & Empowerment of Women Integrating Population Concerns into Development Planning.

Some important reproductive right r/t Reproductive Health

Right to lead a responsible and satisfied sex life. Right to reproduce and freedom to decide when and how often to do so. Right to be informed about advantages , possible risks and side effects.

Right to have free , equal and unhindered access to safe , effective , affordable and acceptable method of fertility regulation Right to get access to appropriate health service of good quality to go through safe pregnancy and child birth.

Reproductive Health Services in Nepal

Reproductive Health is not new programme for Nepal but it has adopted different models in the past forty year to reduce high fertility , and high mortality and maternal mortality rate. The original model of RH in 1970 focused mainly on fertility control.

In 1980 the relationship between fertility and infant and child mortality was given importance. A new paradigm of RH has been emerged at the International conference of Population and Development (ICPD) in 1994.This model encompasses broader concept of RH that has considered basic human rights , Human development and individual well beings at all stages of life.

Nepal is a signatory of ICPD and committed to itself to improve Reproductive health status throughout the nation. Reproductive health in Nepal has integrated existing safe motherhood , family planning , HIV/AIDS , STI , child survival , post-abortion care and adolescent reproductive health programme .

Component of Reproductive Health
The Nepal Reproductive Health Strategy lists the following Reproductive Health issues as priorities in its integrated Reproductive Health Package.

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Family Planning Safe motherhood Child Health (newborn) Prevention and management of complication of abortion Reproductive tract infection/Sexually transmitted Disease / Human Immune – Deficiency Virus /Acquired Immunodeficiency Syndrome.

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Prevention and management of sub fertility. Adolescent reproductive health. Problems with elderly women ( I.e. uterine , cervical and breast cancer treatment ). Gender based violence.

National Reproductive Health Package
The National Reproductive Health Package consist of o Family planning o Safe motherhood o Child health o Prevention and complication of abortion o RTI/STD/HIV/AIDS

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Prevention and management of sub fertility Adolescent reproductive health Problem of elderly women I.e. uterine prolapsed , cervical and breast cancer treatment at tertiary and private level.

The integrated RH package in Nepal is delivered through existing primary health care system , community participation , equitable access and intersectoral collaboration is emphasizes in all aspect of package.

Level of intervention
Family /Decision makers’ level Community level

Sub-health post/Health post level
Primary health care central level District level

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