Sexuality and reproductive health

Efforts to reduce maternal and neonatal mortality are essential if the Millennium Development Goal is to be met. Maternal and neonatal mortality could be reduced if women delivered in settings where skilled attendants could provide emergency obstetric care. The objective of this study was to identify factors which are influencing women to receive delivery care at home in rural Bangladesh. A total of 3300 women were interviewed from 22 sub-districts in Bangladesh who had delivered a birth within one year preceding the survey. Findings reveal that more than 80 percent deliveries were placed at home where about 60 percent women perceive that there was no necessity to go to a facility for delivery. Although there are some factual reasons like economic (19percent), religious and cultural (7percent) still their perception on delivery care in not up to the mark. Other socio- economic and demographic factors also influencing home deliveries include women’s education, occupation, income, number of children and number of parity, economic status, knowledge and practice of safe delivery. Considering this situation, providing financial support through a program like Demand Side Financing may encourage women to use institution or skilled provider for delivery rather than home.

This study focuses on the relationship between violent conflict and the timing of young women’s first sexual intercourse before marriage in Rwanda during 1990-2000. Rwanda was one of the African countries most affected by AIDS and also experienced civil war leading up to genocide in 1994. It is believed that violent conflict can affect the epidemiology of HIV/AIDS. The epidemiology of HIV may be exacerbated or inhibited, as conflict shatters individual lives and communities, depending on the characteristics of the conflict and the regional ecology of HIV. The study makes use of unique data on violent conflict at regional level in Rwanda that are linked to the sexual histories of individual women. I find that there is an increased risk of first sexual intercourse during years of conflict. This could possibly operate through contextual effects on sexual behavior, which could be voluntary sexual experience or forced sexual experience. Lack of parental and community control and rape being used as weapon of war are major theoretical pathways through which conflict could produce increased risk of experiencing first sex and increase the exposure opportunity and risk for STIs and HIV.

ABSTRACT
The present study is based on data screened at ICTC, I.M.S., B.H.U., Varanasi. Among 2806 females cases, 341 (i.e. 11.8%) were HIV positive. The percentage distribution of HIV positivity was 3.56, 14.73 and 18.54 in the age groups 15-24, 25-34 and 35-49 years respectively. This shows that as the age increases, HIV positive cases also increase and there was significant difference in the positivity percentage of HIV and the age groups (2 = 93.58, p<0.001). The percentage distribution of having experiences of multiple sexual contacts in HIV positive females is 60.34. The relative risk (R.R.) is 11.32 and 95% C.I. is 11.06-11.593. The positivity of HIV infection is also high (11.7%) and significant among women having the history of migration. The prevalence of infection is also high (17.33) in rural areas in comparison to 5.36% in urban areas. The co-morbidities were absent in 37.35% cases whereas 62.65% were with one or more morbidities. The significant morbidities with HIV infection were fever, weight loss, weakness, loose motion, T.B., cough, anorexia and others including STD symptoms and AIDS symptoms.

Various studies on sexuality shows men and women have different perception towards sexuality. For men sexual pleasure includes size of penis, penetrative sex, length of intercourse, sexual postures, and multiple partners. There are various products (Aphrodisiac) available like Viagra, penis spray, energy capsules etc. for men for extra sexual pleasure. The objectives of the study are to understand the felt need for these products among men, to understand the sexual behaviour under the influence of these products and to study its mental, physical, reproductive and sexual heath impact on female partners. The study shows that theses products are easily available in the market without prescription. Men belonged to different age group have different reasons to buy these products. Female partners complained severe physical fatigue, guilt and anger. Men avoid using condom under the influence of these products. There is strong need to improve communication between men and women about sexuality.

The female condom introduced in India two decades ago but in spite of Indian government support and social marketing it failed to generate awareness and demand among CSWs ( commercial sex workers) and general population. It is assumed that , Female Condom will give Indian women the freedom to take control over their bodies, their reproductive health, it was seen by many gender rights experts as a tool to empower women. The present study was conducted with CSWs, college going adolescent girls and chemists. Qualitative and quantitative methods were use to understand the awareness, knowledge about female condom, the factors determining use and non use of female condom and to explore the strategies to sustain use of female condom. The study reveals that low awareness, misconception about functionality of female condom, conservative views about sex, high cost, ignorance, lack of availability, discomfort, lack of publicity are key issues preventing chemist from stocking it and people buying and using it.

The frequent contraceptive discontinuation among spacing method users, not only poses women
to a very high risk of unintended pregnancy but also exhibits the lesser conscious approach of
women to control their childbearing in India. In this context a large number of births preceded by
a contraceptive discontinuation/failure may be reported as unintended retrospectively.
Utilizing calendar data of National Family Health Survey (2005-06) this paper tries to estimate
the proportion of pregnancies reported as unintended/intended following the contraceptive
discontinuation and associated characteristics of the women.
The results suggest that 71% of the pregnancies following a method failure were reported as
unintended in comparison to 25% pregnancies which were not preceded by any contraception.
Among women who discontinued their method for reasons other than pregnancy, around 50%
reported their respective birth as unintended. The results from multivariate logistic regression
hint that the time-elapsed between contraceptive discontinuation and the index birth, age at the
time of conception, parity and place of the residence are the significant predictors of reporting a
pregnancy as intended/unintended retrospectively.

In contrast to declining trend of the share of traditional methods in developing world, India has witnessed a gradual increase in traditional method use from 4% in 1992-93 to 8% in 2005-06 (shares 44% of spacing method use). The experience of accidental pregnancy among traditional method users is much high (one-fourth experienced failure within a year) than the modern spacing method. In addition, the use and continuity of modern spacing methods remained low and varies across users and methods in the country. A substantial proportion of method failures result into abortion or still birth posing serious consequences to the women.
In this context, this paper measures the level of abortion as a result of method failure among reversible method users and examines the correlates of abortion. Calendar data from the National Family Health Survey-3 (2005-06) were analyzed. Binary logit models were applied to analyze the determinants of fetal loss. The findings suggest that 75% of the pregnancies preceded by a method failure were carried to term and about 54% of them were reported as unintended. Fetal loss was found to be associated with age, early marriage, parity of the woman, fertility intentions, educational attainment, wealth status and duration of use.

Since the levels of health and health care use are better in urban areas, the study of existing social and economic inequalities is neglected. Considering the importance and neglect of research in this area in India, this study aims to examine socio-economic inequality in maternal health care using latest data from a nationally representative survey. Using Concentration index, the level of socio-economic inequality has been measured in terms of three basic indicators of maternal health care : full antenatal care, safe delivery, and postnatal care. Though level of inequality is moderate at national level, state level variations are considerable in all three indicators.It is found that poorer states like Bihar and Uttar Pradesh have lower levels of maternal health care use and higher levels of socio-economic inequality. On the other hand states like Kerala and Tamil Nadu have almost universal coverage of maternal health care and hence almost no inequality. It is also worth nothing the states in North India have a large share in national urban population. Thus they require immediate attention not only terms of raising level of utilization of maternal health care but also reduction of existing inequality.

The changes in the concept of unmet need for family planning over time have led to inconsistent results across surveys. In a recent attempt, the MEASURE DHS program revised the definition of unmet need. Applying the revised and original definitions, this study measures the unmet needs for family planning in a representative sample of 700 married women, interviewed in the 2012 Mahabad Fertility Survey in Iran. Based on the revised definition, 10.8 percent of women faced an unmet need for family planning, including 7.7 percent for birth spacing and 3.1 percent for birth stopping proposes. The corresponding estimates for the original definition were respectively 9.6, 6.0 and 3.6 percent. Also, about 10 percent of women who used traditional contraceptive methods, largely withdrawal, wished to use modern methods. Taking into account this unmet need for modern methods, we estimate an overall 20.8 percent of unmet needs for family planning in the city of Mahabad based on the revised definition that is 1.3 percent more than the estimate based on the original definition. The observed gap in the original and revised estimates is consistent with the gaps found in the surveys of 70 countries in the literature.

Adolescent sexual activity in sub-Saharan Africa is plagued with health consequences which are further exacerbated among its urban poor populations. Studies have identified various factors that influence the sexual aspects of youth in the sub-region but have scarcely examined the role of sexually explicit media. Pornography, whether seen through print, television, film or the internet, is recognized as a contributor to adolescent sex. Thus, using quantitative methods, this study sought to investigate the relationship between exposure to pornographic movies and pre-coital and coital experiences among 12 to 24 year old youth residing in an urban poor community in Accra. Results suggest that respondents who had ever watched a pornographic movie were more likely to have pre-coital experiences, i.e. kissed and/or fondled a member of the opposite sex, and sexual intercourse. In addition, those who enjoyed watching pornographic movies were more likely to have pre-coital experiences. These outcomes were similar to those in studies conducted among US, Australian, Singaporean and Thai youth. Albeit a controversial issue, this subject requires more attention from researchers and adolescent sexual & reproductive health advocates in sub-Saharan Africa, to enable a thorough examination of pornography’s impact on sexual activity among youth.