Sexuality and reproductive health

Doc: 03
Title; Rural community care in HIV/AIDS management in west Africa: The case of Nigeria
Author: Bob, B. B and Bob,B.B (2012)Journal: The 1st African Regional Educational HIV/AIDS submits,Abuja, ICEDCP. 2011, Nov (1) 12-20)
Source: African Journal: The 1st African Regional Educational HIV/AIDS Submit/ICEDCP

Abstract: Poster
Human Immunodeficiency virus(HIV) and Acquired Immunodeficiency syndrome(AIDS) affect many people, all experiencing their own individual devastating tragedy, the epidemic in Nigeria and many other African sorties is largely invisible and insidious when it begins, is now seen in what once were considered unlikely sites - the rural communities people with HIV/AIDS continue to fight illness and die in appalling conditions and ruin many rural villages, towns, and cities, a mixture of politics, culture and other sensitive still prevent effective high impact education programmed and other strategies to enhance effective response to the disease

Abstract
Background: Infertility is a major medical condition that affects many married couples in sub-Saharan African and as such associated with several social meanings.
Methods: This study used in-depth, key informant interviews and focus group discussions with infertility couples, fertile couples, and key informants to understand the cause of infertility. Results: The study revealed that infertility was caused by both social and biological factors. Socially couples could become infertile through supernatural causes such as bewitchment, and disobediences of social norms. Abortion, masturbation and use of contraceptives were also identified as causes of infertility. Most childless couples seek treatment from spiritualist, traditional healers and hospital.
Conclusion: Childbearing is highly valued in the community and Childlessness is highly engendered, and stigmatized in this community with manifold social consequences. In such a community therefore, the concept of reproductive choice must encompass policies that make it possible for couples to aspire to have the number of children they wish.

Drinking during pregnancy is currently defined as a serious public health problem in all Western countries. In the paper we analyze recent Swedish public health campaigns against drinking during pregnancy. Our data consist of campaign material produced by Swedish National Institute of Public Health and Swedish National Food Administration. The research question is tripartite. First, we analyze how drinking during pregnancy is defined in the public health campaigns as a health risk by using specific kind of scientific knowledge. Secondly, we ask what kinds of techniques the health campaigns recommend for women to restrain from drinking during pregnancy. Thirdly, we study how the health campaign messages address women. Do they address women as rational decision-makers by neutral risk information or as irrational and emotional actors by sentimental, exaggerated and fear raising risk images? The study will increase the understanding of how scientific research is used in the public health campaigns. It will also be informative in specifying how women can be addressed in the public health interventions as rational decision-makers or emotional actors or in both ways. This kind of information is much needed when developing rational and egalitarian alcohol policies, health campaigns and prevention projects.

The study sought to ascertain what motivates PLHIV to provide care and support for fellow PLHIV in Ghanaian hospitals and during home visits, despite the fact that they do not receive any salaries. Data for the study were obtained from 120 purposively selected PLHIV serving in Ghanaian hospitals and clinics across the length and breadth of the country as ‘models of hope’ for fellow PLHIV who have been newly diagnosed of having HIV through a questionnaire and in-depth interview. The purposive sampling technique was employed to select the sample size. Qualitative and quantitative methods were adopted for the study. Results of the study were analysed using the Statistical Product for Social Services (SPSS). The theoretical framework for the study is the exchange theory. A major result was that the respondents were motivated by the fact that they wanted the newly diagnosed PLHIV to have some hope and live positively with HIV.

Keywords: Human Immunodeficiency Virus (HIV), Acquired Immune Deficiency Syndrome (AIDS), Hope, Models of Hope, Training, Incentives, Benefits

The rising trend of caesarean section (CS) delivery throughout the world has become a serious public health issue. In India the rate of CS has increased from 3% to 10% between 1992-93 and 2005-06 (IIPS, 2007). The present study seeks to explore the level and trend of caesarean section delivery in India. It also attempts to identify the causes of alarming growth rate of CS in some parts of India. The analysis is based on third District Level Household and Facility Survey and three rounds of National Family Health Survey conducted in India. Logistic regression model is used to understand the net impact of various explanatory variables on woman’s experience of CS. A number of doctors and patients from different public and private institutions were interviewed to identify the underlying causes of high growth rate of CS. Besides the profit maximization tendency of the private medical institutions, rise in institutional deliveries and patients’ choice for CS, poor doctor-population ratio, 24 hours unavailability of obstetricians in the medical institutions, poor infrastructural support for normal delivery, constant threat of case suits and physical harassment against doctors are cited as some of the important causes of increase in caesarean section delivery.

Objective: To assess the knowledge, attitude and practice regarding pre-marriage counseling among young women in Punjab province of Pakistan.
Study Design: Cross sectional Study in Punjab province, Pakistan
Methodology: The Primary tool in this study was a designed and pretested questionnaire to elicit women’s knowledge and attitudes about pre-marital counseling in Punjab, Pakistan

The Study was conducted to assess the Knowledge, attitude and practices (KAP) of women regarding pre-marriage counseling and to evaluate the correlation between this KAP and indicators of reproductive health and family planning.
Education system is the major factor for not being exposed to pre-marriage counseling. In this study, we tried to fund the reasons for lack of pre-marriage counseling and found that 1) poor literacy rate in Pakistan, and poor coordination and corporation among the participating. 2) cultural barriers and lack of family support to enable to find platforms which women get counseling facilities . 3) Lack of discipline and skill among counselors in performing their responsibilities. 4) lack of interest among counsels. 5) Need to focus on Pre-marriage and relationships during pre-marriage counseling sessions. Need for Pre-Marriage Counseling Program (PMCP) which correlate to reproductive health and family planning

Unintended pregnancies constitute a major public health challenge in most – developing and developed - countries, yet there is no convincing theory to explain their occurrence. Existing theoretical explanations are largely ad hoc, and surprisingly pay little attention to sex, the raison d'e ̂tre for contraception. This paper develops a theory of contraception based on sex and the degree of undesirability of the consequences of sexual activity. Defining sexual activity in terms of the human sexual response cycle, we note that sex is motivated by a desire for sexual pleasure, social relationships, and procreation. Variation in the desirability of these three consequences of sex, along with clear differences in the timing of their appearance, and differences in the uncertainty of their occurrence, provides the relevant sexual context for contraceptive use. While contraception is clearly aimed at avoiding conception, its underlying reasons may be very specific (health or desired family size) or non-specific and aimed quite simply at maintaining existing life styles. We model these aspects of sex and contraception using a model of human behaviour wherein behaviour and its constitutive actions are the result of varying degrees of deliberation; some more reflexive, others more reflective.

The complication of the postpartum complications started with the delivery and it is severe after the two month of the delivery and it is related to a variety of personal, family and social economic variables. This paper makes an attempt to present a model that describes women’s health over the first/last postpartum year and the relationships between health changes and other variables. The core model’s dependent variable is combination of the two variables which describes PPC i.e., high vaginal bleeding and high fever after two months. The independent variables within the model include, social/health support, complication of the child birth, mother use of alcohol and chewing tobacco, beetle leaf, smoking cigarettes, and the economic and demographic characteristics. This model proposed as a research tool for future investigation in Postpartum Complications and as a conceptual framework to enhance our understanding of the relationships between Postpartum Complication and other important variables.

Key words: Age of the mother, Body Mass Index, Wealth, Habit, Religion, Delivery Complications, Region.

Risky sexual behavior, defined as having multiple sexual partners or having unprotected sex, is considered to be rampant in urban areas where extramarital sexual networking is more prevalent due to weak values and norms on sexual behavior. Multiple sexual partnerships aggravates problems associated with sexual health, including HIV/AIDS infection. The present study examined multiple sexual partnerships among 3,022 males (15- 59 years) and females (15- 49 years) urban residents interviewed at the 2008 Ghana Demographic and Health Survey. The findings show that the average number of sexual partners was 1.18; the minimum was one (1) and the maximum was ten (10). Ten percent of the respondents had more than one sexual partner. The percentage of males with two or more sexual partners was approximately five times higher than that of females. Results of the binary regression models showed that males, the never married, the poor and the wealthiest were more likely to engage in risky sexual behavior than others. The intermediate variable- belief of HIV risk- was not statistically significant in the model. Ghana must intensify the condom use and behavior change campaign and target those subgroups of the population who engage in risky sexual behavior.

Rising overmedicalisation of childbearing in low income countries is seen as a worrying phenomenon as resources are scarce and could create a further risk for mother and child’s health. Some Indian States have seen sky rocketing c-section rates reaching twice as high levels than the recommended WHO 15%. It is not clear whether this increase is determined by demand or supply. The aim of this study is to understand the interaction between health systems and individual socio-economic factors in determining the probability of a c-section .
Multilevel modelling at district and cluster level is used to analysed the 2007-8 Indian DHLS..
Results show that after controlling for key risk factors, private institutions have a higher risk to perform c-sections. On the demand side higher education levels rather than wealth seems to increase the likelihood of a c-section. While cluster level is not significant, district level effects are significant in all the states demonstrating the need to control for health systems factors. This research shows that at this stage supply factors might be stronger than demand. It confirms the need to invest in further research to understand whether the quest for increased institutional deliveries in a country with a high maternal mortality might not be compromised by a push for overmedicalisation.