Poster session on Sexuality and reproductive health (1)

The aim of this paper is to investigate the association between reproductive health service provision and its differentials. The study used data from Demographic and Health Surveys and Utilization of Essential Service Delivery Survey of Bangladesh. Public facilities still the major source of modern contraceptive methods among the poor women (66.6%) as compared to the women from richest quintile (26.8%). Seeking of ANC from medically trained providers is significantly higher among the richest quintile (87.4%) as compared to 30.4 percent among the poorest quintile. The well-off usually rely on the private facilities for ANC services as compared to the poor. The socio-economic status has positive impact on the likelihood of delivering at a health facility. The likelihood of preferring private facility relative to public facility in terms of family planning services is increasing over time given the other variables in the model are held constant. Despite expansion of the private sector and NGO sector, the public sector remains an important source of supply for poor women. More attention should be given to the determinants of reproductive health, associated with their interaction with service provision, to reduce maternal mortality and to achieve the MDG for maternal mortality.

Based on the theory of fertility control this paper estimates the effect of gender preference on induced abortions. Using data from the 2003 Korean National Fertility Survey, KLIPS and Population Census, we examine the effect of number of sons and benefits from sons over daughters on induced abortion in Korea. Contraceptive methods are also introduced into the model. The results suggest a positive correlation between the number of sons and induced abortions for the group who intended to have a child. Besides, the relative importance between two motives for induced abortion is correlated with the choice of contraception. In addition, contraceptive failure is proved to be one of the reasons for induced abortion.

Issues of abortion are critical in Ghana largely due to its consequences on sexual and reproductive health. While the practice is generally regarded illegal, the negative perception society attaches to it makes it difficult for young people to access the service and share their experiences. This paper explores the pre and post abortion experiences of young people; a subject scarcely researched in the country. Clients of Planned Parenthood Association of Ghana (PPAG) Clinic at Cape Coast constituted the study population. The interview guide was used to collect data from twenty-one respondents between the ages of thirteen and twenty-four. Guided by the bio-psychosocial model, the study revealed that thoughts of causing ‘murder’, guilt, fear of societal stigma, shame, and loss of partners, leaving with the guilt of ‘murder’ as well as self-imposed stigma were the pre and post abortion experiences the respondents encountered. Bleeding, severe abdominal pains and psychological pain were also reported. Research must focus more in this area. PPAG Clinic must integrate psychosocial treatment in its abortion services while intensifying behaviour change communication and community-based stigma-reduction education in the Metropolis.

Female visitors of the website of the Association of Reproductive Health of Serbia during 2011 were asked to fulfill specially designed questionnaire, if aged 19-20 years. The number of respondents to 25 selected questions varied from 1,600 to 5,700. The characteristics of common personality were defined according to the most frequent reply to particular question. The common girl lives in the city (78%), with parents (53%), in functional families (78%), and belongs to higher socioeconomic level (47%). She declares having many friends (44%), going out several times per month (45%), consuming alcohol several times per year (47%), and having no experience with drug (76%). Common respondent is a university student, financially completely relying on parents (67%) She had first sexual intercourse at the age of 17 (20%). If sexual active, she is heterosexual (91%), had sexual experience with one partner (46%), and regularly achieve orgasm (37%). She prefers condom (44%), hasn’t been pregnant (90%), and hadn’t been diagnosed sexual transmitted diseases (85%). Her main motive for sexual activity is being in love (64%). At the same time, in a significant proportion of respondents were identified serious problems which may affect sexual and reproductive health.

Recent anthropological findings about the meanings of sexuality among Mexicans report a gendered pattern of sexual initiation among men and women. Male first sexual intercourse often has a ritual character, under peer pressure, where young men have to prove their masculine identity in order to gain full admission to the rank of adult men. This important transition does not need to end in marriage.
In contrast, women need to conserve their virginity until marriage. Female sexual initiation involves emotional ties and almost always means the beginning of women’s conjugal and reproductive lives.
Having in mind these anthropological findings about sexual initiation in Mexico as well as the changing social context of the country, we explore data of the National Survey on Reproductive Health of 2003. The objective is to compare, from a gender perspective, male and female experiences among several generations and social groups, in order to explore the existence of changes over time and to identify different patterns in the way the first sexual intercourse is experienced by Mexican population.

This paper analyses the performacne of the family planning programme in India in the context of the goals and objectives of the National Population Policy 2000. The analysis is based on a Fertility Transition Index that has been developed for the purpose and that captures the two dimensions of fertility transtition - delayed child bearing and birth spacing and small family - articulated in the Policy. Using the data available through the 2001 population census and 2007-08 District Level Household and Facility Survey, the analysis reveals that there has been little change in the fertility transition index in India between 2001 and 2007. The analysis also reveals that gains in the dimension of small family norm have been upset by poor performance in the dimension of delayed child bearing and birth spacing. The paper stresses the need for focussing on addressing the unmet need of contraception for spacing to hasten the pace of fertility transition and proposes an alternative - outcome-based - system of monitoring the implementation of official family welfare programme, the mainstay of family planning efforts in the country.

The main objective of this paper is to review the first 40 years’ experience of induced abortion in South Australia and to examine its demographic implications. So far South Australia is the only State where induced abortion is legal in Australia.

Information on abortion was obtained from the annual abortion reports presented to the South Australian Parliament.

The average annual number of abortions was 2,451 in 1970-74, reaching a peak of 5,555 in 1995-99 and has since declined to 4,948 in 2005-09. The corresponding abortion rates were 9.8, 17.3 and 13.2 abortions per 1,000 women of reproductive ages. The increase in abortion rates has affected most age groups – particularly among women under 30 years of age. With the increasing adoption of vacuum aspiration and provision of improved services, complications have been greatly reduced. Concurrent sterilisation has markedly declined from more than 16% in 1970-74 to <1% in 2005-09.

During the first 7-8 years of legalisation of abortion the fertility rates declined substantially. However, since then they have been more or less constant at below replacement levels despite the upward trend in abortion rates. This is probably because of the increasing availability and use of contraception.

The latest Pakistan Demographic and Health Survey 2006-07 indicates stagnation in contraceptive use for almost a decade at 30%. The gap between ever and current use is increasing along with high discontinuation rates. However, results from a recently implemented family planning project in 14 districts of Pakistan show improvements in CPR and contraceptive continuation rates by 8.5 and 11 percentage points respectively. Using survival analysis and the decomposition techniques we examine the underlying factors leading to improved continuation rates and their effect in increasing the CPR. The analysis includes monthly contraceptive histories of 10,604 women in the baseline and 9,995 women in the endline survey. Results show that information on the management of side effects provided at the time of method adoption is significantly associated with lower discontinuations, observed in the decrease of discontinuations due to side effects. Findings will not only highlight the importance of continued contraceptive use they will also have serious implications in elevating currently stagnant CPR.

Treatment seeking behaviour for infertility is affected by community’s socio-cultural norms. Using DLHS-3 data this study examines prevalence of infertility among currently married women of 8 EAG states of India that accounts for 45 percent of India’s population. Eight percent Indian and 51 percent EAG states women had infertility problems. The leading states were Bihar, Chhattisgarh and Uttar Pradesh. A significant proportion of women were Hindu, illiterates, aged 20-29 years, had rural background and age at consummation of marriage was less than 18 years. More than two fifth had taken treatment for infertility. Larger proportions of women were rich, Christian, hailed from other backward classes and had higher level of education. Around half Uttarakhand, Chhattisgarh and Orissa women had allopathic treatment but Rajasthan, Jharkhand and Bihar women had religious/traditional treatment. Multivariate analysis indicated that treatment seeking was affected educational and economic status. Allopathic treatment seeking was determined by knowledge factor and treatment cost. Infertility was highest in Bihar but highest proportion of UP women took treatment for infertility. More Bihar women had responded to infertility treatment. There is a need to look at infertility problems as an issue in domain of reproductive health research.

Background: Pakistan is 6th biggest country in the world has a huge population bulge in the young age group (54% under the age of 24, according to census). Culturally, it is a traditional society where sex, reproduction are taken synonymously with marriage and discussion on such issues is considered taboo. Among new infections, adolescents & youths are most vulnerable.

Method: Classroom intervention of RSHR program has been implemented for 9-10 class students who are around 15-16 years old. The components includes reproductive health, sex & sexuality, gender and rights of equality and legal issues like marriage age, 48 schools from Bahawalpur (Southern Region of Punjab, Pakistan) were chosen for the intervention. SHRO forms were prepared and used before & after the class room intervention and analysed through excel program to find out the changes in their knowledge level in respect to RSHR, fertilization, family planning, sex and sexuality.

Results/Conclusion: A remarkable change has been observed in their knowledge and awareness level increased from 31% to 89%. Tehsil wise base line difference of knowledge level has been noted. One of the reasons of the success is the teachers training program prior to class room intervention. The proper teaching and learning materials have also played contribution to this success.