Lec-1_Introduction to Reproductive Health.pdf

Reproductive Health:
Concept & Definition
Dr Nasreen Nahar
MBBS, MPH (RCH). PhD Fellow
Assistant Professor
Dept. of Reproductive and Child Health (RCH)
Bangladesh University of Health Sciences

Session Objectives
At the end of the session the students will
be able to:
 Define Reproductive Health (RH), Maternal Health
 Understand basic concepts of RH
 Enumerate Historical Background of RH
 Explain the life cycle approach of RH
 Understand the paradigm shift from the concept of
Maternal and Child Health and Family Planning (MCH/FP)
to Reproductive Health.

Introduction
Reproductive health is a universal concern,
but is of special importance for women
particularly during the reproductive years
Although most reproductive health problems
arise during the reproductive years, in old
age general health continues to reflect earlier
reproductive life events

Terminology
Assignment 1
 Reproductive Age
 Adolescent
 Neonate
 Infant
 Total gestational period
 Abortion
 Viable age
 Premature delivery
 Term pregnancy
 Post term pregnancy

Introduction cont…..
Men also demand specific reproductive health
needs and have particular responsibilities in
terms of women's reproductive health
Reproductive health is a fundamental component
of an individual’s overall health status and a
central determinant of quality of life. A healthy
reproductive system makes the miracle of life
possible

What includes in Reproductive &
Sexual Health
 Reproductive Health is part of
“health”
 RH addresses the reproductive
processes, functions, and systems
at all stages of life
 RH implies that people are able to
have a responsible, satisfying, and
safe sex life
 People (including the youth) should
have capability to reproduce and
freedom to decide if, when, and
how often to do so.

Female reproductive tract :Internal Female reproductive tract : External view
Female Reproductive Tract

Definition and Concept of
Reproductive Health
The concept of reproductive health arose in
the 1980s with a growing movement away
from population control and demographic
targets towards a more holistic approach to
women’s health. It was not until the ICPD in
1994 and the Fourth World Conference on
Women (FWCW) in 1995 that the concept
gained international acceptance and was
indicated as a turning point for women’s
health.

ICPD Definition of Reproductive Health
“Reproductive health is a state of complete physical,
mental and social well-being and not merely the
absence of disease or infirmity in all maters relating
to the reproductive system and to 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”

Cont…..
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.”

Lec-1_Introduction to Reproductive Health.pdf

Newborn
health
Child health
Adolescent health
Services
and
systems
Maternal health
Partner
involvement
Sexual and
reproductive health
Continuum of care for women and children

RH…..A Life Cycle Approach
 Reproductive health is a crucial feature of
healthy human development and of
general health.
 It may be a reflection of a healthy
childhood, is crucial during adolescence,
and sets the stage for health in
adulthood and beyond the reproductive
years for both men and women.

Cont…
 Reproductive life span does not begin
with sexual development at puberty and
end at menopause for a woman or
when a man is no longer likely to have
children. Rather, it follows throughout
an individual’s life cycle and remains
important in many different phases of
development and maturation.

Cont…..
 At each stage of life, individual reproductive
health needs may differ. However, there is a
cumulative effect across the life course, and
each phase has important implications for
future well-being.
 An inability to deal with reproductive health
problems at any stage in life may set the
scene for later health problems. This is
known as the life cycle perspective for
reproductive health.

Maternal Health
According to WHO:
 Maternal health refers to the health of
women during pregnancy, child birth ,
and post partum period (6 wks or 42
days after pregnancy)

Development of
Reproductive Health

Historical Perspective
 1974- Bucharest Meeting on population
The key issue at Bucharest was international
acceptance of the World Population Plan of
Action.
Population policies became widespread in
developing countries during the 1970s and
1980s and were supported by UN agencies
and a variety of NGOs.

History…
 The dominant paradigm argued that rapid
population growth would not only hinder
development, but was itself the cause of
poverty and underdevelopment. And
population policies focused on the need to
restrain population growth.

History…
 Before 1978 Alma-Ata Conference
Basic health services in clinics and health
centers
 1978- Alma Ata Primary Health Care
Declaration
• MCH services started with more emphasis on
child survival
• Family planning was the main focus for
mothers

History…
 The concept of reproductive health arose in
1980s
 1981– The Family Planning Evaluation
Division was renamed the Division of
Reproductive Health.
 1982– World Health Organization (WHO)
designates DRH as a Collaborating Center in
Perinatal Mortality and in Family Planning.

History…
 1984- Mexico meeting
Family planning facilities made more available
 Safe motherhood initiative in 1987
• Emphasis on maternal health
• Emphasis on reduction of maternal mortality

History…
 Reproductive health, ICPD (Cairo) in 1994:
 Emphasis on quality of services
 Emphasis on availability and accessibility
 Emphasis on social injustice
 Emphasis on individuals woman's needs
and rights
 Fourth World Conference on Women
(FWCW) Beijing in 1995 :
Universal access to RH by 2015

About ICPD
The International Conference on Population and
Development (ICPD) was held in Cairo, Egypt, from
5 to 13 September 1994. Delegations from 179
States took part in negotiations to finalize a Program
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.

History...
ICPD conference in 1994
Women empowerment for achieving sustainable
development
 Reproductive rights are inextricable from basic
human rights
 Focus changed towards a more holistic approach:
MCH to RCH
 Promotion of healthy reproductive lives VS
prevention of morbidity
 Men’s role were recognized
 Child survival were emphasized
 Integration of RSH services into primary healthcare

History…
 Millennium development goals and reproductive
health in 2000
 MDG 4, 5 and 6 are directly related to health,
 while MDG 1,2,3, and 7 are indirectly related
to health
 World Summit 2005, declared universal access
to reproductive health by 2015
 Sexual and reproductive health is fundamental
to the social and economic development of
communities and nations, and a key component
of an equitable society.

Evolution
In September 1994, the ICPD marked the
beginning of the paradigm shift from the
concept of Maternal and Child Health and
Family Planning (MCH/FP) to Reproductive
Health.

Evolution…
It followed some important occurrences that
made the world to think of other ways of
approach to reproductive health. Three
elements are of particular importance
behind the paradigm shift that Cairo
represents and that has been reinforced in
the recent special session of the UN
General Assembly.

Evolution…
 First was the growing strength of the
women’s movement and their criticism
of the over-emphasis on the control of
female fertility and by extension, their
sexuality to the exclusion of their other
needs.

Evolution…
 A second key development was the advent of
the HIV/AIDS pandemic; suddenly it became
imperative to respond to the consequences
of sexual activity other than pregnancy, in
particular sexually transmitted diseases.
But perhaps more important, it became
possible (and essential) to talk about sex,
about sexual relations outside of marriage as
well as within it, and about the sexuality of
young people.

Evolution…
 A third development, that brought a unity to
the others, was the articulation of the concept
of reproductive rights. An interpretation of
international human rights treaties in terms of
women’s health in general and reproductive
health in particular gradually gained
acceptance during the 1990s.

Thus the 1994 ICPD has been marked as
the key event in the history of reproductive
health.

Lec-1_Introduction to Reproductive Health.pdf

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