Introduction to Reproductive Health

Table of Contents

Introduction to Reproductive Health

Reproductive health is defined as a state of complete physical, mental and social well being and not merely the absence of the disease or infirmity on all matters related to reproductive function and its processes involved.

This is a process concerned with peoples‘ ability to have a responsible satisfying and safe sex life, their capability to reproduce and having the freedom to decide if, when and how often to do so.

Reproductive health includes having:

Satisfying, safe sex life.
Ability to reproduce.
Successful maternal and infant survival outcome.
Freedom to control reproduction.
Information about and access to safer, effective and affordable methods of family planning. 6. Ability to minimize gynecological disease throughout life.

The components of Reproductive Health

Safe motherhood:

∙ Preconception care
∙ Antenatal care
– Maternal nutrition
– Focused antenatal care
– Immunization for tetanus, hepatitis B etc.
– EMTCT of HIV/AIDS
∙ Clean safe delivery
∙ Emergency obstetric care
∙ Postnatal (newborn care) and postpartum care
∙ Breastfeeding/ infant feeding
∙ IEC and community mobilization
∙ Post abortion care services

Family planning:

∙ Medical eligibility for family planning services
∙ Provision of contraceptives and natural family planning
∙ Emergency contraceptive
∙ Management and follow-up for side effects of contraceptives
∙ Infection prevention and quality care

STIs/HIV/AIDS:

∙ Behavioral change counseling
∙ Condom promotion and distribution
∙ Counseling and testing
∙ STI management and treatment
∙ Infection prevention and quality of care
∙ Partner notification and treatment
∙ Treatment compliance.

Sexual and adolescent health:

∙ Behavior change counseling
∙ Provision of adolescent friendly services
∙ Provision of contraceptive services
∙ Screening and management of STIs

Infertility:

∙ Investigation and treatment
∙ Partners‘ involvement

Reproductive organ cancers:

∙ Screening and referral
∙ Definitive management
∙ Palliative care

Gender related issues; such as gender based violence, sexual abuse, female genital mutilation and fistulae.

∙ Advocacy
∙ Partner involvement
∙ Community involvement
∙ Specialized management
∙ Multi-sectorial collaboration
∙ Legal support

Menopause and andropause:

∙ Symptomatic treatment
∙ Hormonal replacement
∙ Partner involvement
∙ Advise on exercise and nutrition

Importance of reproductive health

Promotion of maternal and child health
Reduces maternal morbidity and mortality
Promotes free women‘s involvement in all matters related to reproductive health issues e.g. family planning
Promotes prompt treatment and detection of life threatening cases throughout reproductive life
It promotes safer sex practices and reduces the incidence of rampant sexual related abuses
. Reduces on government expenditure on reproductive related health issues thus promotes quality standard of living.

Problems being faced during the implementation of Reproductive Health in Uganda

The following are some of the problems being encountered during the implementation of reproductive health services in Uganda;

Low socio-economic status (poverty): This is the major setback as many people in Uganda live within poverty level which in turn makes them unable to access even the least costly services. For instance, the Uganda Demographic Health Survey shows that mortality rates are high in women from low socio-economic status as these women are likely to be less privileged in the fields of nutrition, housing, quality education etc
Improper/underutilization of the existing services
Delivery of substandard care i.e. when the care provided is below the generally accepted level available at that particular coupled up shortages of resources and under-equipped facilities
Lack of communication and referral facilities: This could be due to poor coordination between lower health facilities with the higher ones backed-up by geographical barriers, transport means like ambulances etc.
Poor cultural perspectives on reproductive health; variety of cultural practices are the basic obstacles to Reproductive Health Services for instance, female genital mutilation, early marriages, denying women to eat certain foods etc.
Lack of awareness by the community on issues related to reproductive health.
Inadequate supply of resources related to reproductive health. This therefore makes the little existing services disproportionately consumed by the overwhelming individuals who visit the health Centers.
Inadequate skilled staff specially trained on issues pertaining reproductive health. The number of skilled staff to deliver various Reproductive Health Services in Uganda is appalling as compared to the number of clients who desperately need the scarce services.
Improper evaluation and supervision of reproductive health services to ascertain its progress and successes
Lack of support from men, opinion leaders and development partners as they are considered change agents in the community
Misappropriation and embezzlement of funds specially designed to facilitate reproductive health services.

Ways through which Reproductive Health Service can be improved in Uganda

It is a coordinated long term effort within the families, opinion leaders, communities and health systems.

It also involves the national legislation and policies where action may vary in respect of an individual and the government ought to make Reproductive Health a priority of public concern and to periodically evaluate the program to ascertain the successes.

A good quality of obstetric services and referral services are to be considered.
Proper and timely evaluation of the Reproductive health related issues are to be taken a priority.
Recruitment of skilled manpower at the functional referral points for proper integration of reproductive health services to fill the pending gaps.
Decentralization of services to make them available in time.
Social inequalities and discrimination on grounds of gender, age and marital status are to be removed.
Timely supply of essential reproductive health services to meet the overwhelming number
Women should be empowered to gain access to education, economic and social status in order to increase women’s decision making power in regards to their own health and reproduction.
Sensitization to create awareness should be given to the community, society and decision makers about the values of reproductive health.
Improving on the standard delivery of care by organizing refresher courses (workshop and for the health care personnel at various level others
Barriers to access of health facilities should be addressed
Proper utilization of services available
Bad cultural practices and beliefs in the community should be discouraged. This can be done by strict laws, for instance illegalization of female genital mutilation, sexual gender based violence, early marriages etc.
Penalizing those who have been found culprits for misusing the funds.
Encouraging men and community members to actively and wholeheartedly support their partners through their active participation in RHS being provided