REPRODUCTIVE HEALTH

Dr. Farhat R Malik

Assistant Professor

Community Health Sciences

SESSION OBJECTIVES

Define Reproductive Health.

Scope of Reproductive Health.

Components of RH.

Reproductive Rights

 MDG’s and Sustainable development goals

RH- Indicators

Pakistani Situation

Reproductive Health

Health as a state of complete physical, mental and socialwell-being, and not merely the absence of disease orinfirmity.

Reproductive health addresses the reproductiveprocesses, functions and system at all stages of life.

Reproductive health, therefore, implies that people areable to have a responsible, satisfying and safe sex life andthat they have the capability to reproduce and thefreedom to decide if, when and how often to do so.

COMPONENTS OF RH

1.Safe Motherhood.

2.Fertility Regulation.

3.Prevention & control of RTIs.

4.STIs & HIV/AIDS

5.Infertility.

6.New born care.

7.Male Involvement.

8.Reproductive tract Cancer detection & Management.

9.Comprehensive Family Planning Services.

What are Reproductive Rights?

Attaining the goals of sustainable, equitable development requires thatindividuals are able to exercise control over their sexual andreproductive lives. This includes the rights to:

Reproductive health as a component of overall health, throughout thelife cycle, for both men and women

Reproductive decision-making, including voluntary choice in marriage,family formation and determination of the number, timing and spacingof one's children and the right to have access to the information andmeans needed to exercise voluntary choice

Equality and equity for men and women, to enable individuals to makefree and informed choices in all spheres of life, free fromdiscrimination based on gender

Sexual and reproductive security, including freedom from sexualviolence and coercion, and the right to privacy.

RH/FP

Relevance: There is a clear relationship between the indicator and FP/RH;

Accuracy: The indicator measures what it purports to measure;

Importance: The measurement captures something that "makes a difference" inprogram effectiveness;

Usefulness: The results point to areas for improvement. Furthermore, theindicator captures information that helps move FP/RH strategies, priorities, orprogramming forward;

Feasibility: Data can be obtained with reasonable and affordable effort;

Credibility: The indicator has been recommended - and is being used - by leadingexperts and organizations such as WHO, UNAIDS, and UNFPA;

Validity: To the extent possible, the indicator has been field-tested (including thosemeasured in Demographic and Health Surveys (DHS) and Reproductive HealthSurveys (RHS)) or used in practice; and

Distinctiveness: The indicator lacks redundancy and does not measure somethingalready captured under other indicators.

Shortlist of indicators for global monitoring of Reproductive Health

1 - Total fertility rate

2- Contraceptive prevalence

3- Maternal mortality ratio

4 - Antenatal care coverage

5 - Births attended by skilled health personnel

6 - Availability of basic essential obstetric care

7 - Availability of comprehensive essential obstetric care

8 – Peri natal mortality rate

9 - Prevalence of low birth weight

10 - Prevalence of positive syphilis serology in pregnant women

11 - Prevalence of anemia in women

12 - Percentage of obstetric and gynecological admissions owing to abortion

13 - Reported prevalence of women with genital mutilation

14 - Prevalence of infertility in women

15 - Reported incidence of urethritis in men

16 - Prevalence of HIV infection in pregnant women

17 - Knowledge of HIV-related preventive practices

INDICATORS

LIFE EXPECTANCY AT BIRTH.

MATERNAL MORTALITY RATE.

INFANT MORTALITY RATE.

PERINATAL MORTALITY RATE.

INDUCED ABORTION RATE.

NEONATAL MORTALITY RATE.

TOTAL FERTILITY RATE.

AGE SPECIFIC FERTILITY RATE.

UNMET NEED FOR FAMILY PLANNING.

CONTRACEPTIVE PREVALENCE RATE.

PREVALENCE OF HIV AMONG PREGNANT FEMALES.

SCOPE OF RH

Global attention ,ICPD in 1994.

Pakistan committed to holistic approach to RH care.

Part of general health.

Developing countries – 18% burden of disease Infemales ( 15-49yrs ) is due to maternal causes.

16% contribute to STDs & HIV.

Globally 0.58 million maternal deaths/ year, 99% arein developing world.

COMPARISON

SITUATION IN PAKISTAN

Estimated Total Population180.8 M

Lifetime Risk of Maternal Death 1 woman in 93

Maternal Mortality Ratio 260 per 100,000 LB

Total Fertility Rate 3.07

Births Attended by Skilled Health Provider 39%

Unmet Need for Family Planning 33%

Total Fertility Rate

Definition : Average number of children that would beborn per woman if all women lived to the end of theirchildbearing years and bore children according to agiven fertility rate at each age.

1988

2000

2001

2010

2012

6.2

4.56

4.41

3.4

3.07

PAKISTAN

The status of maternal health ispoor in Pakistan.

An estimated 30,000 women dieeach year due to pregnancy relatedcauses.

It is estimated that about 500maternal deaths occur per 100,000live births each year in Pakistan.

Recent estimates (WHO &UNICEF) place the figures around270/100,000 live births but inreality it may be higher because ofunder registration of deaths incountry and absence of cause ofdeath information.