Sexuality and reproductive health

A cross-sectional study was done using the women’s data set from the 2008 Nigeria Demographic and Health Survey to determine factors associated with the utilization of postpartum care services among Nigerian women during their last childbirth in the five years preceding the survey. With postpartum care utilization at 44.9% and timely provision of care within 24 hours of childbirth at 33.3%, postpartum services remain a poor and neglected area of maternal health services in Nigeria. Age, marital status, parity, place of residence, region, level of education, wealth, religion and all three forms of media exposure were shown to be associated with utilization of postpartum care services. However after controlling for confounding factors all but daily radio listening and daily television watching were significant predictors. While not all categories of these individual characteristics turned out to be significant predictors, some of those that were significant had a positive influence on utilization of postpartum care services, while others had a negative influence. It is necessary to conduct further studies using these predictors to find out why and how they influence the health care seeking behaviors of women. The findings from this study should form the basis for interventions to increase the rate of utilization of postpartum care

Background: The main purpose of this study investigates the relationships and assesses the potential roles of socio-health factors on Human Immunodeficiency Virus (HIV) epidemic in the globe.
Data and methods: We compiled country level indicators of HIV prevalence rates, are contraceptive prevalence rate, physicians density, portion of Muslim populations, adolescent fertility rate, and mean year of schooling of all the countries (N=187) in the globe from the United Nations (UN) agencies. To examine the associations between HIV prevalence rates and to extract major factors from indicators of the later five categories, we carried out backward multiple regression analysis.
Results: The national HIV prevalence rate was significantly correlated with almost all the predictors. Backward multiple linear regression analysis identified the portion of Muslims, physicians density, and adolescent fertility rate are as the three most prominent factors linked with the national HIV epidemic.
Conclusions: The findings support the hypotheses that a higher adolescent fertility rate leads to longer period of sexual activity that increases the risk of HIV infection and social restriction of Muslims and sufficient physicians will decelerate the spread of HIV infections in the society.

The study of sexual behaviour lies at the heart of understanding the reproductive behavior in human populations and the transmission dynamics of sexually transmitted infections including HIV/AIDS. Perhaps the most widely conjectured demographic and health consequences of polygyny and concurrency of sexual partners is their potential effect on the transmission of HIV and other STIs. Yet, while the combination of long-term concurrent sexual partnerships and high infectiousness early in HIV infection has been suggested as a key driver of extensive spread of HIV in general populations in sub-Saharan Africa (SSA), this has never been rigorously investigated within the framework of multiple marital and non-marital sexual partners owing to the complex feature of family structure in settings where polygyny is prevalent. This paper takes advantage of large scale population-based repeated surveys of nationally representative populations from developing countries to assess, within a multilevel framework, the role of family structure dynamics on gender differences in HIV risk and prevalence and how these differences have changed across countries and over time.

National statistics on maternal mortality vary considerably from international estimates: national figures for 2010 showed 5,670 maternal deaths in Latin America, substantially fewer than the 7,400 estimated by UNMMEIG or the 8,263 estimated by IHME. In Latin America, social and geographical inequality results in uneven coverage and quality of vital registration, and insufficient metadata to assess reliability. To facilitate an understanding of the methods, and to assist countries in the conciliation of national estimations with external sources, CELADE/ECLAC drafted a document comparing MMEIG, IHME and country estimates; explaining the approaches for measuring maternal mortality; and shedding light regarding interpretation of the multiple estimation sources.
Further, CELADE is working with eight pilot countries to explore data quality, assessments and adjustments. This paper reports findings of the pilot study, including a review on the coverage and quality of vital statistics; the state of the art of maternal mortality statistics at the national level; and an examination of discrepancies between sources, in the light of available metadata. Conclusions will be discussed with country stakeholders, resulting in recommendations on coordination, harmonization of figures and improvement of maternal mortality measurement.

Background: Studies conducted in Bangladesh reported a high maternal mortality ratio for the past decades. Approximately 80 percent girls become mother before they reached age 18. Lack of knowledge on SRHR among adolescents and lack of skills for empowerment are two major factors responsible for this low performance in maternal health sector.
Objectives: To improve reproductive and maternal health of UCEP students by providing SRHR education and life skill based training to delay marriage and subsequent childbearing.
Intervention area: Providing SRHR education to 4 UCEP school students. Organized FGDs to assess the need of SRHR education in the save intervention area.
Intervention process: The study conducted by using SRHR manual for the students with a pre and post test survey. The Findings suggest that knowledge and attitude of adolescent have changed significantly and those who received the education are more knowledgeable on safe motherhood compared to those who have not. Both vicariate and multivariate analyses identified several key factors which have influenced their behavior.
Conclusion: Considering the importance of SRHR education for adolescent, UCEP-Bangladesh engaged their students in SRHR education and life skill vocational trainings to reduce early marriage and economic dependency.

In recent years, the role of the state in provision of public services is being reexamined around the world with many experiment in alternative service delivery structures. India is at the forefront of some of these innovative programs which include one of world’s largest conditional cash transfer programs – payment to women and community health workers for hospital delivery as well as health insurance program for the poor where government pays the premiums for use of government as well private health facilities. These investments should improve maternal health outcomes including use of prenatal care, hospital delivery and postnatal care.
However, these programs are set up in a context where public service delivery systems remain indifferent to patient welfare, private health systems are poorly monitored and gender norms and intra-household inequalities constrain women’s ability to seek health care. Thus, careful evaluation of these programs and their impact is necessary to understand their effectiveness and ability to reach the poorest.
Using unique nationally representative longitudinal survey of over 40,000 households conducted before and after , this paper examines the impact of India’s Janani Suraksha Yojana (JSY), a conditional cash transfer program for hospital delivery, for improving access to maternal care.

The Katanga Province in the south-east of DRC covers an area of 496,877 square kms with an estimated population over 11.462.290 inhabitants out of 68% are under age of 25 ; maternal mortality rate is high 612 per 100.000 live births; the modern CPR is low 2,3%; one in four adolescent girls aged 15-19 has already given birth or been pregnant. HIV prevalence rate is 5,6%. However, local authorities’ financial commitment to advance ICPD agenda is strong. Thus, UNFPA decided to support provincial government’s initiatives where financial commitment is expressed.Three types of programs were identified: i) Maternal and newborn health; ii) Integrating Youth Friendly Services and HIV prevention; iii) Availability of data for development. The key challenge faced was the limited resources of UNFPA and youth community as well. Advocacy and BCC activities, building alliances with media professionals, partnerships, resources mobilization and auto financing were implemented. From 2009 to date, the local government has invested 15,000,000USD for renovation/ construction of over 15 maternity wards and health facilities, 383,000USD for construction of the multifunctional youth center including promotion HIV VCT and 262,901USD for the setting up of a population statistics center to avail accurate data in prevision of the census.

Taking advantage of the recent surge of surgical repairs in recent years to investigate the lives of women post fistula reconstructive surgery in Uganda, our study involving 16 women who had gone through fistula operation in Hoima National referral Hospital (Western Region), Uganda in May 2012 during a fistula operation camp organized by Engender Health.Clinical records were used to find contacts of the women with a fistula historyfound out that no program exists for women after the operation to reintegrate into the society which they once belonged to. Family support was found to be instrumental during and after the fistula operation while community support and perceptions was found to largely negatively affect the quality of life of women during the period of fistula.We recommend that Post operation programs for women be planned to assist them successfully reintegrate into the community.

Background: Men's support is key in improving the uptake of their partners’ sexual and reproductive health (SRH) services, hence contributing to efforts aimed at achieving Millennium Development Goals 4, 5 and 6. The study’s objective was to explore men’s perceptions on and uptake of SRH services in Kenya.
Methods: Data were derived from qualitative interviews conducted with 60 men from communities neighboring facilities that were part of a larger study that assessed the relative benefits of different models of integrated SRH/HIV service provision over separately provided services. Interviews were recorded, transcribed verbatim, translated and analyzed thematically.
Findings: Generally, men felt comfortable seeking SRH services together with their partners. Most services sought together were HIV counseling/ testing and family planning services. Other services, but minimally were HIV care/treatment, antenatal, postnatal, sexually transmitted infections screening/treatment, and condoms provision. Waiting times and service scheduling at facility were some of the barriers that hindered men’s uptake of services.
Conclusions: Study demonstrates that men are receptive to seeking services together with their partners. However, existing barriers need to be addressed in order to increase men’s uptake of SRH services.

Varied forms of structural shifts associated with the process of globalization, including deteriorating state provision of health services, the spread of market ethic, economic polarization and large-scale internal migration, have altered the structural and cultural circumstances of youth access to essential sexual and reproductive health services in contemporary China. In spite of these trends, their profound impacts have never been examined before. Drawing primarily upon data from semi-structured interviews with 45 conveniently selected service providers and managers from 26 health sites in 6 provinces of China between 2009 and 2010, this study seeks to shed light on five interrelated challenges, as an illustration of the adverse impact of globalization. These five effects and dilemmas related to globalized shifts include rising user fees, weakening preventive care, pervasive commercial advertising, poorly unregulated health market, and unequal access to health care, thus contributing to a better understanding of the social determinants of sexual and reproductive health among young people. Findings from the study highlight the Chinese Government should respond to these entangled trends in a more sensitive and integrated way to meet the need of this neglected population in an era of rapid globalization.