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

International
Sexual and
Reproductive
Rights:
A New Way to Work Toward the Improvement of
Women’s Maternal Health

International
“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.

International
United Nations Population Fund
Indonesia
1970’s 1990’s
Population Growth 2.3% → 1.9%
Birth Rate/1,000 40.6 → 27.9
Fertility Rate
Children/Women 6 → 3
Contraceptive Prevalence 49.7 → 54.7
Infant Mortality/1,000 145 → 60

International
United Nations Population Fund
The Philippines
1970’s 1990’s
Population Growth 2.4% → 2.3%
Fertility Rate
Children/Women → 3.4
Contraceptive Prevalence 2.4 → 28-31
Infant Mortality/1,000 45 → 35

International
Health Indicator Database
Canada Indonesia Philippines
Maternal Morbidity
Per 100,000 6 470 246
Lifetime Risk of
Maternal Death 1 in: 8,700 65 96
WHO REPRODUCTIVE HEALTH AND RESEARCH

International
Delivery Attended by
Skilled Health Personnel % 98 55.8 56.4
Antenatal
Care Coverage % 100 82 83

International
Crude Birth
Rate/1,000 11.9 22.5 28.4
Annual Rate of
Population Increase 0.93 1.41 2.03
Population x 1,000 30,757 212,092 75,653

International
Infant Mortality 5.5 48.4 34.4
Male
Child Mortality 5.8 8.5 17.5
Female
Child Mortality 5 40 33

International
Male Life Expectancy
At Birth 76.6 64.4 64.2
Female Life Expectancy
At Birth 81.9 67.4 71.5

International
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

International
Maternal Deaths Around the
World
0
50000
100000
150000
200000
250000
300000
Afrique
Asie

International
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

International
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

International
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

International
Principle causes
of maternal
mortality and
morbidity
Sepsis
14%
Haemorrhage
25%
Indirect
Causes
20%
Other direct
causes
8%
Obstructed
Labour
7%
Complication
s from
unsafe
abortion
13%
Hypertension
13%

International
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

International
3-Delay Model
1.Deciding to seek care
2.Reaching the proper
medical services
3. Accessing quality care

International
Impact of Maternal Deaths
On 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

International
Impact of Maternal Deaths
On families and communities…
• Principal caregiver
• Livelihood
• Productive member of the community

International
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

International
• 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.

International
Safe Motherhood
Essential Services:
•Education, community mobilization
•Prenatal care, including the
promotion of good maternal nutrition
•Skilled attendance during delivery

International
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

International
Health professionals have
an important role to play
in ensuring Safe
Motherhood.

International
Women Seek:Women Seek:
Respect, courtesy, privacyRespect, courtesy, privacy
A provider that understands each women’sA 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

International
Criteria for Women Friendly
Health Services
Quality of care standards and
guidelines
The necessary equipment and
supplies
Accessible services
Available services

International
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.

International
Monitoring and Evaluation ofMonitoring and Evaluation of
Safe Motherhood (SM)Safe Motherhood (SM)
ProgramsPrograms

International
Objectives:
Importance of conducting monitoring and
evaluation activities
What is “maternal mortality”
Defining “maternal mortality” and its
challenges
Alternative monitoring and evaluating
methods

International
Measuring Progress:
A critical intervention for
reducing maternal
mortality

International
Important Questions:
Number of women who have died
Causes of death
How the death could have been prevented

International
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)

International
Common Indicators of
Maternal Mortality
Maternal Mortality Ratios
Maternal Mortality Rates
Lifetime Risks

International
Difficulties in Measuring
Maternal Mortality
Maternal deaths are frequently
under reported and misidentified

International
Methods of Measuring
Maternal Mortality
Vital Registration Systems
RAMOS
Household Survey Using Direct
Estimations
Sisterhood Methods
WHO/UNICEF/UNFPA Estimates

International
Process Indicators
Maternal Death Case Reviews
Verbal Autopsy of Maternal
Deaths
Confidential Enquiries into
Maternal Deaths
Alternative Methods:Alternative Methods:

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