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CHAPTER 16

CHAPTER 16. Global Health in Reproduction and Infants By: Carol Holz and Suzanne Grisdale. Background Poor or inadequate sexual and reproductive health contributes to one third of the world’s burden of disease for women of childbearing age and one fifth of the total world population

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CHAPTER 16

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  1. CHAPTER 16 Global Health in Reproduction and Infants By: Carol Holz and Suzanne Grisdale

  2. Background • Poor or inadequate sexual and reproductive health contributes to one third of the world’s burden of disease for women of childbearing age and one fifth of the total world population • The Global Burden of Disease Initiative • Sexual and reproductive health issues represent 18% of the world’s total burden of disease and 32% of the burden of women of childbearing age (15-44 years) • Disability adjusted life years (DALYs) • Definition of Reproductive Health

  3. Reproductive Rights • The United Nations’ Programme of Action of the International Conference on Population and Development, 1995 • Adolescent Reproductive Health • Menarche (the age at which reproduction is physically possible) varies greatly across societies • In the U.S. about one million adolescents ages 11-19 become pregnant every year and 500,000 give birth • 14 million young women worldwide ages 15-19 gave birth each year

  4. Teenage pregnancy rates have declined during the last 25 years in developed countries • Abortion rates for teenagers in developed countries vary greatly • Sexually transmitted diseases disproportionately affect teenagers as compared to older women of childbearing age • Syphilis • Gonorrhea • Chlamydia

  5. Cultural Influences • Fertility • Men are physiologically capable of reproducing longer than women and often marry later and become fathers at older ages than women • Culture • Infertility • The biological failure to conceive by normal sexual activity without contraception • Inability to carry a pregnancy to full term • Cultural and Religious Issues

  6. Family Planning and Contraception INSERT TABLE 16-1 WORLDWIDE CONTRACEPTIVE USE

  7. Most common forms of contraception in the United States: • Oral contraceptive pill • Female sterilization • Male condom • Male sterilization • Injectable Depo-Provera • Nearly 98% of all women who have had sexual intercourse have used at least one type of contraception • Emergency Contraception

  8. Abortion • Elective Abortion is the voluntary termination of a pregnancy • History of Elective Abortion • Childbirth by Choice Trust (1999) • World Perspectives • Presently, two thirds of the world’s population allows abortion upon request

  9. INSERT TABLE 16-2 ABORTION RATES OF 14-44 YEAR-OLDS, 1999

  10. Maternal Mortality and Morbidity • The Maternal Mortality Rate: the number of maternal deaths per 1000,000 women of reproductive age for a specific period of time (usually one year) • Causes of maternal mortality worldwide are ranked: • Hemorrhage • Sepsis • Hypertensive disorders • Abortion complications • Obstructive labor

  11. Accessing Reproductive Health Care • Prenatal care reduces maternal and newborn complications through regular checkups • Two United Nations millennium development goals (MDG’s) • Likelihood of mothers entering prenatal care increases with age and education and decreases with numbers of children

  12. Infant Health • Infant Mortality • Infant Mortality Rate • Neonatal Mortality Rate • Early Neonatal Morality Rate • Late Neonatal Morality Rate • Late Fetal Mortality Rate • Perinatal Mortality Rate • Low-Birth Weight Rate • Moderately Low-Birth-Weight Rate • Very Low-Birth-Weight Rate • Term – Births at 37-41 weeks • Preterm – Births at less than 37 completed weeks

  13. INSERT TABLE 16-5 SELECTED US INFANT MORTALITY RATES PER STATE

  14. Causes of neonatal deaths include: • Preterm births (low birth weight) • Severe infections (sepsis, pneumonia, tetanus, and diarrhea • Asphyxia • Congenital abnormalities • Infant Abandonment in China • Diarrhea in Children in Developing Countries

  15. Sexually Transmitted Diseases (STDs) • Prevention and Treatment Care • HIV Infection and Reproduction • About 700,000 children under 15 years of age are infected with HIV every year in the world • The World Health Organization recommends exclusive breastfeeding from birth to 6 months of age

  16. Violence Against Women • United National Declaration on the Elimination of Violence Against Women of 1993 • Female Genital Mutilation • Also called female circumcision • Type I – Excision of the prepuce • Type II – Excision of the clitoris & labia minora • Type III – Excision of part or all of the external genitalia & stitching/narrowing of the opening (infibulation) • Type IV – Pricking, piercing, or incision of the clitoris and/or labia

  17. Male Reproductive Health • Men is sub-Saharan Africa have a significant reduction in life span • Men had their first sexual encounter by age 20 • Male and female sterilization is common in males and females in developed countries • STDs are highest in men in sub-Saharan Africa, Latin America and Caribbean areas • HIV/AIDS rates are the highest in the world in sub-Saharan African men and women

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