Introduction to Reproductive Health

Dr. Addisu Tadesse Sahile

[email protected]
ORCID ID : (0000-0001-5925-6324)
Cell phone: +2519 12096667

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 Objectives

• Understand historical development of reproductive

health

• Describe reproductive health concepts and definitions

• Identify components of reproductive health

• Describe reproductive health rights

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 Historical Development of RH

• Special needs of children recognized since old times

• Existing medical disciplines were unable to deal
with the reproductive health problems
• MCH services were provided on ad-hoc basis

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• Public responsibility for MCH services in the 19th
century and 20th century
– In USA and Europe, organization of MCH services

• MCH spread to the developing world

– By charitable organizations until WWII

– Governments were more concerned with the provision of

curative care to urban populations and control of epidemics

• WHO identified MCH as one of the priorities

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• Concern about population growth in 1960s

• Rapid increase in availability of contraceptive

technologies

• WHO established a program to develop new methods

and improve existing ones

• Population policies became widespread in developing

countries during the 1970s &1980s

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• Rapid population growth seen as cause of poverty
and underdevelopment
• Family planning programs based on top-
down approaches
• Success evaluated against numeric goals and targets

• Many developing countries did not show much

progress

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• The significance of MCH was restated at Alma-ata in
1978
• Child survival introduced in the early 1980s by
UNICEF and others
• The Safe Motherhood Initiative launched in 1987
– Response to ignorance of the maternal health

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• International Conference on Population and Development
(ICPD), in Cairo, 1994
– marked the beginning of a new era

– adoption of comprehensive definitions of RH,

sexual health and reproductive rights

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 A Paradigm Shift (1990s)

• Theory-Human beings and human rights are at the center

of concerns for sustainable development.

• Policy-Advancing human rights, especially gender

equality, equity and empowerment of women are key to
population and development related programs.

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 The Paradigm Shift
• Possible to stabilize population while attending to
health needs and respecting rights
• Recognition of the needs in sexuality
and reproduction beyond fertility regulation

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 Impetus for the Paradigm Shift

1. Growing strength of the women’s movement

– criticized over emphasis on controlling female

fertility

2. Advent of the HIV/AIDS pandemic

3. Articulation of sexual and reproductive rights

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 The 2030 Agenda for
Sustainable Development
Goal (SDG)

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 – Reducing the global maternal mortality ratio to less than 70
per 100,000 live births (target 3.1)

– Ending preventable deaths of newborns & children

under 5 years of age (target 3.2);

– Ensuring universal access to sexual and reproductive

health-care services, including family planning,
information and education (target 3.7).
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– Eliminating all harmful practices, such as child, early and
forced marriage and female genital mutilation (target 5.3).

– Ensuring universal access to sexual and reproductive health

and reproductive rights (target 5.6).

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 Dev’t of RH Services in Ethiopia

– FGAE was established in 1967 (FP introduced for the fist

time in Ethiopia)

– Attempts to integrate family Planning in to MCH program

of the Ministry of Health ( 1979)

– Family health Department established (1987)

– Population Policy developed (1993)

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 – RH concept introduced in Ethiopia
after ICPD (1994)

– National RH needs assessment done (1997)

– Ethiopia became the signature of

the MDGs (2000)

– National RH strategy developed in 2006

– National Adolescent and youth RH

strategy developed in 2007

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 RH Concepts and Definitions

• Reproductive health is…..

“ 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.”

– International Conference on Population and

Development,
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Program of Action, 1994.
The definition suggests that reproductive health
encompasses:
• The ability to reproduce

• Freedom to control reproduction

• The ability to go through pregnancy and childbirth safely, with

successful maternal and infant survival and outcomes
• The ability to obtain information about and access to safe,
effective and affordable methods of family planning

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• The ability to have a satisfying, safe sex life, free from fear of
pregnancy and disease
• The ability to minimize gynecologic disease and risk
throughout all stages of life
• Reproductive health is life-long, beginning even before women
and men attain sexual maturity and continuing beyond a

woman's child-bearing years.

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 Sexuality
• It is a central aspect of being human throughout life
• Encompasses sex, gender identities and roles, sexual orientation,
pleasure, intimacy, and reproduction.

• Sexuality is experienced and expressed in thoughts, fantasies,

desires, beliefs, attitudes, values, behaviors, practices, roles, and
relationships.

• Sexuality is affected by the interaction of biological, psychological,

social, economic, political, cultural, ethical, legal, historical,
religious, and spiritual factors.
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 Sexual Health

• A state of physical, emotional, mental, and social

wellbeing in relation to sexuality; it is not merely
the absence of disease, dysfunction, or infirmity.

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• It includes a positive and respectful approach to
sexuality and sexual relationships,

• The possibility of having pleasurable and safe

sexual experiences that are free of pressure,
discrimination, and violence.

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 Guiding principles in RH
Originated from ICPD declaration:
1. Health is a fundamental human right.

– Everyone has the right to the highest attainable standard of

physical and mental health.

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2. Implementation of the recommendations are the
responsibility and sovereign right of each country
• with full respect for the various religious and ethical
values and cultural backgrounds of its people, and in
conformity with universally recognized international
human rights.

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3. Commitment to the ethical concepts of equity,
solidarity and social justice and to the incorporation of
a gender perspective in SRH strategies.

4. Ensuring that all health services are based on

scientific evidence, of good quality and within
affordable limits, and that they are sustainable for the
future.

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5.Ensuring the availability of the essentials of primary
health care as defined in the Declaration of Alma-Ata.

6.Active participation by and accountability of

individuals, groups and communities, and of
institutions, organizations and sectors in health
development are promoted and facilitated.

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 Components of Reproductive
Health
• RH care is defined as the constellation of:

– Methods,

– Techniques and

– Services

• That contribute to reproductive health and wellbeing

by preventing and solving reproductive health
problems.

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• Family Planning
– Family planning counseling, IEC and services
• Maternity Care
– Education and services for prenatal care, safe
delivery and postnatal care
• Child Health Care
– Breast feeding promotion, Nutrition, growth
monitoring , Immunizations, Sickness care

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• Prevention and treatment of infertility;

• Prevention of abortion, management of its consequences, and

safe abortion where not against the law;
• Adolescent SRH
• Active discouragement of harmful practices;

• IEC on human sexuality, responsible parenthood and

reproductive health;
• Referral for additional services
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 Reproductive rights -ICPD 1994
Three rights in particular were identified:

• The right of couples and individuals to decide freely and

responsibly the number and spacing of children and to have the
information and means to do so;

• The right to attain the highest standard of sexual and

reproductive health; and,

• The right to make decisions free of discrimination,

coercion or violence.

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 Group Discussion Points

• Justify the relevance of reproductive rights to RH?

• What is the status of reproductive rights in

Ethiopia? Give evidence.

• How can we realize reproductive health rights?

• Time is 15 minutes
• 5 minute for presentation 32