Reproductive health
Encyclopedia
Within the framework of the World Health Organization
's (WHO) definition of health
as a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity, reproductive health, or sexual health/hygiene, addresses the reproductive processes, functions and system at all stages of life. Reproductive health, therefore, implies that people are able to have a responsible, satisfying and safer sex life and that they have the capability to reproduce and the freedom to decide
if, when and how often to do so. Implicit in this are the right of men and women to be informed
of and to have access to safe, effective, affordable and acceptable methods of birth control
of their choice; and the right of access to appropriate health care services
of sexual
and reproductive medicine
that will enable women to go safely
through pregnancy
and childbirth
and provide couples with the best chance of having a healthy infant.
According to the WHO, "Reproductive and sexual ill-health accounts for 20% of the global burden of ill-health for women, and 14% for men."
The WHO estimates that each year, 358 000 women die due to complications related to pregnancy and childbirth; 99% of these deaths occur within the most disadvantaged population groups living in the poorest countries of the world. Most of these deaths can be avoided with improving women's access to quality care from a skilled birth attendant
before, during and after pregnancy and childbirth.
(ICPD) was held in Cairo
, Egypt, from 5 to 13 September 1994. Delegations from 179 States took part in negotiations to finalize a Programme of Action on population and development for the next 20 years. Some 20,000 delegates from various governments, UN agencies, NGOs, and the media gathered for a discussion of a variety of population issues, including immigration
, infant mortality
, birth control
, family planning
, and the education of women.
In the ICPD Program of Action, 'Reproductive health' is defined as:
“a state of complete physical, mental and social well-being and...not merely the absence of disease or infirmity, in all matters relating to the reproductive system and its functions and processes. Reproductive health therefore implies that people are able to have a satisfying and safe sex life and that they have the capability to reproduce and the freedom to decide if, when and how often to do so. Implicit in this last condition are the right of men and women to be informed [about] and to have access to safe, effective, affordable and acceptable methods of family planning of their choice, as well as other methods of birth control which are not against the law, and the right of access to appropriate health-care services that will enable women to go safely through pregnancy and childbirth and provide couples with the best chance of having a healthy infant.”
This definition of the term is also echoed in the United Nations Fourth World Conference on Women, or the so-called Beijing Declaration of 1995. However, the ICPD Program of Action, even though it received the support of a large majority of UN Member States, does not enjoy the status of an international legal instrument; it is therefore not legally binding.
The Program of Action endorses a new strategy which emphasizes the numerous linkages between population and development and focuses on meeting the needs of individual women and men rather than on achieveing demographic targets. The ICPD
achieved consensus on four qualitative and quantitative goals for the international community, the final two of which have particular relevance for reproductive health:
Key to this new approach is empowering women and providing them with more choices through expanded access to education and health services and promoting skill development and employment. The Programme advocates making family planning universally available by 2015, or sooner, as part of a broadened approach to reproductive health and rights, provides estimates of the levels of national resources and international assistance that will be required, and calls on Governments to make these resources available.
. To monitor global progress towards the achievement of this target, the United Nations
has agreed on the following indicators:
According to the MDG Progress Report, regional statistics on all four indicators have either improved or remained stable between the years 2000 and 2005. However, progress has been slow in most developing countries, particularly in Sub-saharan Africa
, which remains the region with the poorest indicators for reproductive health. According to the WHO
in 2005 an estimated 55% of women do not have sufficient antenatal care and 24% have no access to family planning services.
a "silent pandemic
". The article states "ending the silent pandemic of unsafe abortion is an urgent public-health
and human-rights imperative." It also states "access to safe abortion improves women’s health, and vice versa, as documented in Romania
during the regime of President Nicolae Ceausescu
" and "legalisation of abortion on request is a necessary but insufficient step toward improving women’s health" citing that in some countries, such as India where abortion has been legal for decades, access to competent care remains restricted because of other barriers. WHO’s Global Strategy on Reproductive Health, adopted by the World Health Assembly in May 2004, noted: “As a preventable cause of maternal mortality and morbidity, unsafe abortion must be dealt with as part of the MDG on improving maternal health and other international development goals and targets." The WHO's Development and Research Training in Human Reproduction (HRP), whose research concerns people's sexual and reproductive health and lives, has an overall strategy to combat unsafe abortion that comprises four inter-related activities :
During and after the ICPD, some interested parties attempted to interpret the term ‘reproductive health’ in the sense that it implies abortion as a means of family planning or, indeed, a right to abortion. These interpretations, however, do not reflect the consensus reached at the Conference.
For the European Union, where legislation on abortion is certainly less restrictive than elsewhere, the Council Presidency has clearly stated that the Council’s commitment to promote ‘reproductive health’ did not include the promotion of abortion. Likewise, the European Commission, in response to a question from a Member of the European Parliament, clarified:
With regard to the US, only a few days prior to the Cairo Conference, the head of the US delegation, Vice President Al Gore, had stated for the record:
Some years later, the position of the US Administration in this debate was reconfirmed by US Ambassador to the UN, Ellen Sauerbrey, when she stated at a meeting of the UN Commission on the Status of Women that:
downloadable material for healthcare professionals worldwide
World Health Organization
The World Health Organization is a specialized agency of the United Nations that acts as a coordinating authority on international public health. Established on 7 April 1948, with headquarters in Geneva, Switzerland, the agency inherited the mandate and resources of its predecessor, the Health...
's (WHO) definition of health
Health
Health is the level of functional or metabolic efficiency of a living being. In humans, it is the general condition of a person's mind, body and spirit, usually meaning to be free from illness, injury or pain...
as a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity, reproductive health, or sexual health/hygiene, addresses the reproductive processes, functions and system at all stages of life. Reproductive health, therefore, implies that people are able to have a responsible, satisfying and safer sex life and that they have the capability to reproduce and the freedom to decide
Family planning
Family planning is the planning of when to have children, and the use of birth control and other techniques to implement such plans. Other techniques commonly used include sexuality education, prevention and management of sexually transmitted infections, pre-conception counseling and...
if, when and how often to do so. Implicit in this are the right of men and women to be informed
Sex education
Sex education refers to formal programs of instruction on a wide range of issues relating to human sexuality, including human sexual anatomy, sexual reproduction, sexual intercourse, reproductive health, emotional relations, reproductive rights and responsibilities, abstinence, contraception, and...
of and to have access to safe, effective, affordable and acceptable methods of birth control
Birth control
Birth control is an umbrella term for several techniques and methods used to prevent fertilization or to interrupt pregnancy at various stages. Birth control techniques and methods include contraception , contragestion and abortion...
of their choice; and the right of access to appropriate health care services
Reproductive medicine
Reproductive medicine is a branch of medicine that deals with prevention, diagnosis and management of reproductive problems; goals include improving or maintaining reproductive health and allowing people to have children at a time of their choosing...
of sexual
Sexual medicine
Sexual medicine is a medical specialty that deals with sexual health. At times heavily influenced by current local views on morality, with heavy cultural overlay, in broad terms this specialty is concerned with diagnosing, assessing and treating all aspects which relate to sexuality.Issues can be...
and reproductive medicine
Reproductive medicine
Reproductive medicine is a branch of medicine that deals with prevention, diagnosis and management of reproductive problems; goals include improving or maintaining reproductive health and allowing people to have children at a time of their choosing...
that will enable women to go safely
Maternal health
Maternal health refers to the health of women during pregnancy, childbirth, and the postpartum period. It encompasses the health care dimensions of family planning, preconception, prenatal, and postnatal care in order to reduce maternal morbidity and mortality.Preconception care can include...
through pregnancy
Pregnancy
Pregnancy refers to the fertilization and development of one or more offspring, known as a fetus or embryo, in a woman's uterus. In a pregnancy, there can be multiple gestations, as in the case of twins or triplets...
and childbirth
Childbirth
Childbirth is the culmination of a human pregnancy or gestation period with the birth of one or more newborn infants from a woman's uterus...
and provide couples with the best chance of having a healthy infant.
According to the WHO, "Reproductive and sexual ill-health accounts for 20% of the global burden of ill-health for women, and 14% for men."
Sexual health
An unofficial working definition for sexual health is that "Sexual health is a state of physical, emotional, mental and social well-being in relation to sexuality; it is not merely the absence of disease, dysfunction or infirmity. Sexual health requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence. For sexual health to be attained and maintained, the sexual rights of all persons must be respected, protected and fulfilled." However, this is not an official WHO position, and should not be used or quoted as a WHO definition.Childbearing and health
Early childbearing and other behaviours can have health risks for women and their infants. Waiting until a woman is at least 18 years old before trying to have children improves maternal and child health. If an additional child is desired, it is considered healthier for mother, as well as for the succeeding child, to wait at least 2 years after previous birth before attempting to conceive. After a miscarriage or abortion, it is healthier to wait at least 6 months.The WHO estimates that each year, 358 000 women die due to complications related to pregnancy and childbirth; 99% of these deaths occur within the most disadvantaged population groups living in the poorest countries of the world. Most of these deaths can be avoided with improving women's access to quality care from a skilled birth attendant
Birth attendant
A birth attendant, also known as “skilled birth attendant” , is a midwife, physician, obstetrician, nurse, or other health care professional who provides basic and emergency health care services to women and their newborns during pregnancy, childbirth and the postpartum period...
before, during and after pregnancy and childbirth.
International Conference on Population and Development (ICPD), 1994
The International Conference on Population and DevelopmentInternational Conference on Population and Development
The United Nations coordinated an International Conference on Population and Development in Cairo, Egypt from 5–13 September 1994. Its resulting Program of Action is the steering document for the United Nations Population Fund ....
(ICPD) was held in Cairo
Cairo
Cairo , is the capital of Egypt and the largest city in the Arab world and Africa, and the 16th largest metropolitan area in the world. Nicknamed "The City of a Thousand Minarets" for its preponderance of Islamic architecture, Cairo has long been a centre of the region's political and cultural life...
, Egypt, from 5 to 13 September 1994. Delegations from 179 States took part in negotiations to finalize a Programme of Action on population and development for the next 20 years. Some 20,000 delegates from various governments, UN agencies, NGOs, and the media gathered for a discussion of a variety of population issues, including immigration
Immigration
Immigration is the act of foreigners passing or coming into a country for the purpose of permanent residence...
, infant mortality
Infant mortality
Infant mortality is defined as the number of infant deaths per 1000 live births. Traditionally, the most common cause worldwide was dehydration from diarrhea. However, the spreading information about Oral Re-hydration Solution to mothers around the world has decreased the rate of children dying...
, birth control
Birth control
Birth control is an umbrella term for several techniques and methods used to prevent fertilization or to interrupt pregnancy at various stages. Birth control techniques and methods include contraception , contragestion and abortion...
, family planning
Family planning
Family planning is the planning of when to have children, and the use of birth control and other techniques to implement such plans. Other techniques commonly used include sexuality education, prevention and management of sexually transmitted infections, pre-conception counseling and...
, and the education of women.
In the ICPD Program of Action, 'Reproductive health' is defined as:
“a state of complete physical, mental and social well-being and...not merely the absence of disease or infirmity, in all matters relating to the reproductive system and its functions and processes. Reproductive health therefore implies that people are able to have a satisfying and safe sex life and that they have the capability to reproduce and the freedom to decide if, when and how often to do so. Implicit in this last condition are the right of men and women to be informed [about] and to have access to safe, effective, affordable and acceptable methods of family planning of their choice, as well as other methods of birth control which are not against the law, and the right of access to appropriate health-care services that will enable women to go safely through pregnancy and childbirth and provide couples with the best chance of having a healthy infant.”
This definition of the term is also echoed in the United Nations Fourth World Conference on Women, or the so-called Beijing Declaration of 1995. However, the ICPD Program of Action, even though it received the support of a large majority of UN Member States, does not enjoy the status of an international legal instrument; it is therefore not legally binding.
The Program of Action endorses a new strategy which emphasizes the numerous linkages between population and development and focuses on meeting the needs of individual women and men rather than on achieveing demographic targets. The ICPD
International Conference on Population and Development
The United Nations coordinated an International Conference on Population and Development in Cairo, Egypt from 5–13 September 1994. Its resulting Program of Action is the steering document for the United Nations Population Fund ....
achieved consensus on four qualitative and quantitative goals for the international community, the final two of which have particular relevance for reproductive health:
- Reduction of maternal mortality: A reduction of maternal mortality rates and a narrowing of disparities in maternal mortality within countries and between geographical regions, socio-economic and ethnic groups.
- Access to reproductive and sexual health services including family planning: Family planningFamily planningFamily planning is the planning of when to have children, and the use of birth control and other techniques to implement such plans. Other techniques commonly used include sexuality education, prevention and management of sexually transmitted infections, pre-conception counseling and...
counseling, pre-natal care, safe delivery and post-natal care, prevention and appropriate treatment of infertilityInfertilityInfertility primarily refers to the biological inability of a person to contribute to conception. Infertility may also refer to the state of a woman who is unable to carry a pregnancy to full term...
, prevention of abortionAbortionAbortion is defined as the termination of pregnancy by the removal or expulsion from the uterus of a fetus or embryo prior to viability. An abortion can occur spontaneously, in which case it is usually called a miscarriage, or it can be purposely induced...
and the management of the consequences of abortion, treatment of reproductive tract infections, sexually transmitted diseases and other reproductive health conditions; and education, counseling, as appropriate, on human sexuality, reproductive health and responsible parenthood. Services regarding HIVHIVHuman immunodeficiency virus is a lentivirus that causes acquired immunodeficiency syndrome , a condition in humans in which progressive failure of the immune system allows life-threatening opportunistic infections and cancers to thrive...
/AIDSAIDSAcquired immune deficiency syndrome or acquired immunodeficiency syndrome is a disease of the human immune system caused by the human immunodeficiency virus...
, breast cancerBreast cancerBreast cancer is cancer originating from breast tissue, most commonly from the inner lining of milk ducts or the lobules that supply the ducts with milk. Cancers originating from ducts are known as ductal carcinomas; those originating from lobules are known as lobular carcinomas...
, infertility, delivery, hormone therapyHormone therapyHormone therapy, or hormonal therapy is the use of hormones in medical treatment. Treatment with hormone antagonists may also referred to as hormonal therapy...
, sex reassignment therapySex reassignment therapySex reassignment therapy is an umbrella term for all medical procedures regarding sex reassignment of both transgender and intersexual people...
, and abortion should be made available. Active discouragement of female genital mutilation (FGM)Female genital cuttingFemale genital mutilation , also known as female genital cutting and female circumcision, is defined by the World Health Organization as "all procedures that involve partial or total removal of the external female genitalia, or other injury to the female genital organs for non-medical reasons."FGM...
.
Key to this new approach is empowering women and providing them with more choices through expanded access to education and health services and promoting skill development and employment. The Programme advocates making family planning universally available by 2015, or sooner, as part of a broadened approach to reproductive health and rights, provides estimates of the levels of national resources and international assistance that will be required, and calls on Governments to make these resources available.
Millennium Development Goals
Achieveing universal access to reproductive health by 2015 is one of the two targets of Goal 5 - Improving Maternal Health - of the eight Millennium Development GoalsMillennium Development Goals
The Millennium Development Goals are eight international development goals that all 193 United Nations member states and at least 23 international organizations have agreed to achieve by the year 2015...
. To monitor global progress towards the achievement of this target, the United Nations
United Nations
The United Nations is an international organization whose stated aims are facilitating cooperation in international law, international security, economic development, social progress, human rights, and achievement of world peace...
has agreed on the following indicators:
- 5.3: contraceptive prevalence rate
- 5.4: adolescent birth rate
- 5.5: antenatal care coverage
- 5.6: unmet need for family planning
According to the MDG Progress Report, regional statistics on all four indicators have either improved or remained stable between the years 2000 and 2005. However, progress has been slow in most developing countries, particularly in Sub-saharan Africa
Sub-Saharan Africa
Sub-Saharan Africa as a geographical term refers to the area of the African continent which lies south of the Sahara. A political definition of Sub-Saharan Africa, instead, covers all African countries which are fully or partially located south of the Sahara...
, which remains the region with the poorest indicators for reproductive health. According to the WHO
Who
Who may refer to:* Who , an English-language pronoun* who , a Unix command* Who?, one of the Five Ws in journalism- Art and entertainment :* Who? , a 1958 novel by Algis Budrys...
in 2005 an estimated 55% of women do not have sufficient antenatal care and 24% have no access to family planning services.
Reproductive Health and abortion
An article from the World Health Organization calls safe, legal abortion a "fundamental right of women, irrespective of where they live" and unsafe abortionUnsafe abortion
An unsafe abortion is the termination of an unwanted pregnancy by persons lacking the necessary skills, or in an environment lacking minimal medical standards, or both...
a "silent pandemic
Pandemic
A pandemic is an epidemic of infectious disease that is spreading through human populations across a large region; for instance multiple continents, or even worldwide. A widespread endemic disease that is stable in terms of how many people are getting sick from it is not a pandemic...
". The article states "ending the silent pandemic of unsafe abortion is an urgent public-health
Public health
Public health is "the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals" . It is concerned with threats to health based on population health...
and human-rights imperative." It also states "access to safe abortion improves women’s health, and vice versa, as documented in Romania
Romania
Romania is a country located at the crossroads of Central and Southeastern Europe, on the Lower Danube, within and outside the Carpathian arch, bordering on the Black Sea...
during the regime of President Nicolae Ceausescu
Nicolae Ceausescu
Nicolae Ceaușescu was a Romanian Communist politician. He was General Secretary of the Romanian Communist Party from 1965 to 1989, and as such was the country's second and last Communist leader...
" and "legalisation of abortion on request is a necessary but insufficient step toward improving women’s health" citing that in some countries, such as India where abortion has been legal for decades, access to competent care remains restricted because of other barriers. WHO’s Global Strategy on Reproductive Health, adopted by the World Health Assembly in May 2004, noted: “As a preventable cause of maternal mortality and morbidity, unsafe abortion must be dealt with as part of the MDG on improving maternal health and other international development goals and targets." The WHO's Development and Research Training in Human Reproduction (HRP), whose research concerns people's sexual and reproductive health and lives, has an overall strategy to combat unsafe abortion that comprises four inter-related activities :
- to collate, synthesize and generate scientifically sound evidence on unsafe abortion prevalence and practices;
- to develop improved technologies and implement interventions to make abortion safer;
- to translate evidence into norms, tools and guidelines;
- and to assist in the development of programmes and policies that reduce unsafe abortion and improve access to safe abortion and highquality postabortion care
During and after the ICPD, some interested parties attempted to interpret the term ‘reproductive health’ in the sense that it implies abortion as a means of family planning or, indeed, a right to abortion. These interpretations, however, do not reflect the consensus reached at the Conference.
For the European Union, where legislation on abortion is certainly less restrictive than elsewhere, the Council Presidency has clearly stated that the Council’s commitment to promote ‘reproductive health’ did not include the promotion of abortion. Likewise, the European Commission, in response to a question from a Member of the European Parliament, clarified:
With regard to the US, only a few days prior to the Cairo Conference, the head of the US delegation, Vice President Al Gore, had stated for the record:
Some years later, the position of the US Administration in this debate was reconfirmed by US Ambassador to the UN, Ellen Sauerbrey, when she stated at a meeting of the UN Commission on the Status of Women that:
See also
- Abortion debateAbortion debateThe abortion debate refers to discussion and controversy surrounding the moral and legal status of abortion. The two main groups involved in the abortion debate are the self-described "pro-choice" movement and the "pro-life" movement...
- Contraceptive securityContraceptive securityContraceptive security is a situation in which people are able to reliably choose, obtain, and use quality contraceptives for family planning and sexually transmitted disease prevention when they want them....
- DemographyDemographyDemography is the statistical study of human population. It can be a very general science that can be applied to any kind of dynamic human population, that is, one that changes over time or space...
- ICPD: International Conference on Population and DevelopmentInternational Conference on Population and DevelopmentThe United Nations coordinated an International Conference on Population and Development in Cairo, Egypt from 5–13 September 1994. Its resulting Program of Action is the steering document for the United Nations Population Fund ....
- POPLINEPOPLINEPOPLINE is a reproductive health database, containing citations with abstracts to scientific articles, reports, books, and unpublished reports in the field of population, family planning, and reproductive health issues...
: World's largest reproductive health database- The INFO ProjectThe INFO ProjectThe INFO Project is housed at the Johns Hopkins Bloomberg School of Public Health Center for Communication Programs and is funded by the United States Agency for International Development....
- The INFO Project
- Reproductive justiceReproductive justiceReproductive justice is a concept linking reproductive health with social justice. The term emerged from the work of reproductive health organizations for women of color in the United States in the 1990s.-Overview:...
- Reproductive rightsReproductive rightsReproductive rights are legal rights and freedoms relating to reproduction and reproductive health. The World Health Organization defines reproductive rights as follows:...
- Organizations:
- Association of Reproductive Health ProfessionalsAssociation of Reproductive Health ProfessionalsThe Association of Reproductive Health Professionals is a non-profit organization founded in 1963 by Alan Frank Guttmacher. It is a membership association with members who are nurse practitioners, nurse midwives, pharmacists, physician assistants, physicians, researchers, educators, and other...
- Centre for Development and Population ActivitiesCentre for Development and Population ActivitiesThe Centre for Development and Population Activities is an international nonprofit organization dedicated to improving the lives of women and girls in developing countries through education, health and training programs.-History:...
- EngenderHealthEngenderHealthEngenderHealth is a 501 nonprofit organization based in New York, internationally active in contraception, HIV and AIDS, gender equity, obstetric fistula, sterilization, and other sexual and reproductive health issues in dozens of developing countries around the world.- Mission statement :From its...
- Guttmacher InstituteGuttmacher InstituteThe Guttmacher Institute is a non-profit organization which works to advance sexual and reproductive health. The institute operates in the United States and globally "through an interrelated program of social science research, policy analysis and public education." According to their mission...
- German Foundation for World PopulationGerman Foundation for World PopulationThe German Foundation for World Population is an international non-governmental organisation addressing Sexual & Reproductive Health and population dynamics...
- International Planned Parenthood FederationInternational Planned Parenthood FederationThe International Planned Parenthood Federation is a global non-governmental organization with the broad aims of promoting sexual and reproductive health, and advocating the right of individuals to make their own choices in family planning. It was first formed in 1952 in Bombay, India, and now...
- Marie Stopes InternationalMarie Stopes InternationalMarie Stopes International is an International Non-Governmental Organisation working on Sexual and Reproductive Health with headquarters in London, UK. It is named after Marie Stopes, a Scottish author, campaigner for eugenics, women's rights, and a pioneer in the field of family planning...
- United Nations Population FundUnited Nations Population FundThe United Nations Population Fund is a UN organization. The work of the UNFPA involves promotion of the right of every woman, man and child to enjoy a life of health and equal opportunity. This is done through major national and demographic surveys and with population censuses...
- Association of Reproductive Health Professionals
External links
- Meaning of Sexual Health - Magnus Hirschfeld Archive for Sexology
- Information on reproductive health and assisted reproduction technologies in the UK
- Euromapping Annual Report of Official Development AssistanceOfficial development assistanceOfficial development assistance is a term compiled by the Development Assistance Committee of the Organisation for Economic Co-operation and Development to measure aid. The DAC first compiled the term in 1969. It is widely used by academics and journalists as a convenient indicator of...
contributions to Sexual and Reproductive Health from European donor countries - CDC Division of Reproductive Health
- F-risky... are you? - information on all aspects of sexual health
- Deptartment of Population, Family and Reproductive Health The Johns Hopkins Bloomberg School of Public Health
- Resources for HIV/AIDS and Sexual and Reproductive Health Integration The Johns Hopkins Bloomberg School of Public Health, Center for Communication Programs
- The Johns Hopkins INFO Project —a knowledge-sharing resource on family planning and reproductive health
- SexInfo University of California, Santa Barbara
- A CICRED book for download on reproductive health
- One Source Reproductive Health search results
- Women's Global Network for Reproductive Rights Network that links grassroots organizations
- Health-EU Portal Sexual Health in the EU
- The Global Library of Women's Medicine Non-profit offering freely
downloadable material for healthcare professionals worldwide
- www.Unobetta.com Inspirational Help Guide: How to become pregnant when told it's impossible!