Ch01 s sexual and reproductive health ppt

Sexual and Reproductive Rights

International ALARM International Canadian Faculty

George Carson, MD, FRCSC - Regina, Saskatchewan

Eileen Hutton, Registered Midwife, PhD - Vancouver, British Columbia

Jaelene Mannerfeldt, MD, FRCSC - High River and Calgary, Alberta

Ferdinand Pauls, BSc(med), Dip Trop Med, MD, FRCSC - Winnipeg,

Manitoba

Liette Perron, Program Officer, International Women’s Health - Ottawa,

Ontario

Thirza Smith, MD, FRSCS - Saskatoon, Saskatchewan


International

ALARM INTERNATIONAL

JAKARTA

16-18 SEPTEMBER 2003


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Sexual and Reproductive

Rights:A New Way to Work Toward the Improvement of

Women’s Maternal Health


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“I am going to the sea to fetch a new baby.The journey is dangerous and I may not return…”

Saying of Tanzanian Women near the time of delivery.


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United Nations Population FundIndonesia

1970’s 1990’sPopulation Growth 2.3% 1.9%Birth Rate/1,000 40.6 27.9Fertility Rate Children/Women 6 3Contraceptive Prevalence 49.7 54.7Infant Mortality/1,000 145 60


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United Nations Population FundThe Philippines

1970’s 1990’sPopulation Growth 2.4% 2.3%Fertility Rate Children/Women 3.4Contraceptive Prevalence 2.4 28-31Infant Mortality/1,000 45 35


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Health Indicator Database

Canada Indonesia PhilippinesMaternal MorbidityPer 100,000 6 470 246

Lifetime Risk of Maternal Death 1 in: 8,700 65 96

WHO REPRODUCTIVE HEALTH AND RESEARCH


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Canada Indonesia PhilippinesDelivery Attended by

Skilled Health Personnel % 98 55.8 56.4

Antenatal Care Coverage % 100 82 83



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Canada Indonesia Philippines

Crude Birth Rate/1,000 11.9 22.5 28.4

Annual Rate of Population Increase 0.93 1.41 2.03Population x 1,000 30,757 212,092 75,653



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Infant Mortality 5.5 48.4 34.4

Male Child Mortality 5.8 8.5 17.5

Female Child Mortality 5 40 33



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Male Life ExpectancyAt Birth 76.6 64.4 64.2

Female Life Expectancy At Birth 81.9 67.4 71.5



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What Statistics Tell Us About Women’s R.H.

• 515 000 women die each year - one every minute - from complications of pregnancy and childbirth

• 99% of these deaths occur in developing countries


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Maternal Deaths Around the World

050000

100000150000200000250000300000


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Lifetime Risk of Maternal Death•Africa:

• Bénin: 1 in 15• Morocco: 1 in 30

•Asia:• Afghanistan: 1 in 15• Sri Lanka: 1 in 610

•Amérique latine / Caraïbe• Dominican Republic: 1 in 250• Haiti: 1 in 16


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In addition:• Every year, almost 50 million women experience maternal health problems

• Adolescent are twice as likely to die during pregnancy and childbirth

•50 million unwanted pregnancies are terminated annually


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Furthermore:• 20 million women undergo unsafe abortion.

• There is a direct link between poor maternal health and a newborn’s chance of survival.

• Health risks relate maternal health and HIV/AIDS


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Principle causes of maternal mortality and morbidity

Sepsis14%

Haemorrhage25%

Indirect Causes

20%

Other direct causes

8%

Obstructed Labour

7%Complication

s from unsafe

abortion13%

Hypertension13%


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Socio-economic and Cultural Factors

•Women’s poor health and nutrition•Inadequate, inaccessible or unaffordable health care services•Poor hygiene and care during childbirth•Poverty/lack of information/lack of decision making power


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3-Delay Model1.Deciding to seek care

2.Reaching the proper medical services

3. Accessing quality care


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Impact of Maternal DeathsOn infants and children…•Almost certain death for a newly born infant•2 million children are orphaned annually •Increased probability of older children dying, especially girls•Increased likelihood of children’s absenteeism from school


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Impact of Maternal Deaths

On families and communities…

• Principal caregiver

• Livelihood

• Productive member of the community


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Why are Sexual and Reproductive Rights

Important?A matter of social justice

Improvements in women’s health means:• Equality

•Productivity

•Widespread benefits, especially for children

•High returns on health resources


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• Safe Motherhood:

•The ability of women to receive quality care that is required, in a risk free environment and to be in good health throughout her pregnancy and delivery.


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Safe Motherhood

Essential Services:

•Education, community mobilization

•Prenatal care, including the promotion of good maternal nutrition

•Skilled attendance during delivery


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Safe Motherhood

Essential Services:•Skilled attendance for obstetrical complications•Antenatal Care•Services to prevent and manage complications due to unsafe abortion•Family planning counselling•Reproductive health education for adolescents


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Health professionals have an important role to play

in ensuring Safe Motherhood.


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Women Seek:Women Seek:

Respect, courtesy, privacyRespect, courtesy, privacy

A provider that understands each women’s A provider that understands each women’s situation and needssituation and needs

Complete and accurate informationComplete and accurate information

Access and continuity of careAccess and continuity of care

Fairness and resultsFairness and results


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Criteria for Women Friendly Health Services

Quality of care standards and guidelines

The necessary equipment and supplies

Accessible services

Available services


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Conclusion•Maternal care = a basic human right

•Skilled attendance throughout delivery

•Health care professionals have an important role to play in ensuring women’s access to essential services for Safe Motherhood.


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Monitoring and Evaluation of Monitoring and Evaluation of Safe Motherhood (SM) Safe Motherhood (SM)

ProgramsPrograms


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Objectives:Importance of conducting monitoring and evaluation activitiesWhat is “maternal mortality”Defining “maternal mortality” and its challengesAlternative monitoring and evaluating methods


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Measuring Progress:

A critical intervention for reducing maternal mortality


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Important Questions:

Number of women who have diedCauses of deathHow the death could have been prevented


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Maternal Mortality: the death of a woman while pregnant

or within 42 days of termination of pregnancy, irrespective of the duration and the site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management, but not from accidental causes. (WHO Definition)


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Common Indicators of Maternal Mortality

Maternal Mortality RatiosMaternal Mortality RatesLifetime Risks


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Difficulties in Measuring Maternal Mortality

Maternal deaths are frequently under reported and misidentified


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Methods of Measuring Maternal MortalityVital Registration SystemsRAMOSHousehold Survey Using Direct EstimationsSisterhood MethodsWHO/UNICEF/UNFPA Estimates


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Process IndicatorsMaternal Death Case ReviewsVerbal Autopsy of Maternal DeathsConfidential Enquiries into Maternal Deaths

Alternative Methods:Alternative Methods:

Date post:	16-Apr-2017
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