Introduction to Reproductive Health 2022/2023 (Tanta University)

**Tanta university** **Faculty of nursing** **Master specialty degree** **2022/2023** **Introduction to reproductive health**  **Under supervision:** **Prof. Dr / Manal Gaheen** **Prepared by:** 1. 2. 3. 4. 5. 6. 7. 8. **Objectives:** **General objective:**...

**Tanta university** **Faculty of nursing** **Master specialty degree** **2022/2023** **Introduction to reproductive health**  **Under supervision:** **Prof. Dr / Manal Gaheen** **Prepared by:** 1. 2. 3. 4. 5. 6. 7. 8. **Objectives:** **General objective:** **At the end of this seminar the student will able to** discuss introduction to reproductive health. **Specific objectives:** **At the end of this seminar, the student will be able to:** - Define reproductive health. - Illustrate importance of reproductive health. - Discuss Factors affecting reproductive health. - List Components of reproductive health - Discuss life cycle approach of reproductive health - Identify needs of childhood stage - Mention the common problems during childhood stage - List strategy to improve girl childhood stage. - Identify the needs of adolescence period - Discuss harmful practice of adolescence stage - identify the Needs of adulthood period of mature women; - mention the Common problems during reproductive stage - discuss Basic elements of reproductive health during mature stage - Discuss Reproductive Health Services - Discuss Reproductive Health rights - Discuss Equality in reproductive health - Discuss Role of maternity nurse in reproductive health **Outlines** - **Introduction.** - **Definition of Reproductive health.** - **Importance of reproductive health.** - **Factors affecting reproductive health.** - **Component of reproductive health:** - **Life cycle approach in reproductive health** - - - - - **Needs of adulthood period of mature women;** - **Common problems during reproductive stage** - 1. 2. 3. 4. 5. - **Reproductive health services.** - **Reproductive health rights.** - **Equality in reproductive health** - **Male involvement in reproductive health.** - **Top Barriers to Reproductive Health Care in the Developing WorldSexual and Reproductive Health Care** - **Role of maternity nurse in reproductive health.** - **References.[\ ]** **[Introduction]** Reproductive health addresses the human sexuality and reproductive processes, functions and system at all stages of life. Every individual has the right to make their own choices about their sexual and reproductive health. To maintain one's sexual and reproductive health, people need access to accurate information and the safe, effective, affordable and acceptable contraception method of their choice. They must be informed and empowered to protect themselves from sexually transmitted infections. And when they decide to have children, women must have access to skilled health care providers and services that can help them have a fit pregnancy, safe birth and healthy baby. Reproductive disorders affect millions of people each year. The WHO assessed in 2018 that reproductive disorders accounts for 20% of the global burden of ill-health for women, and 14% for men. **[Definition of reproductive health ]** 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 to its functions and processes. **[Importance of reproductive health:]** 1. Good reproductive health is important for women's general health and wellbeing during childhood, adolescence and adulthood and affects health of next generation. 2. The reproductive organs are one of the most sensitive organs of the human body and proper care of them is needed to protect oneself from any reproductive disorders. 3. It helps in the prevention of sexually transmitted infections such as AIDS or HIV. 4. Taking proper reproductive health is needed in order to have a safe and satisfying sexual life. It is also a necessity for having healthy children. 5. Reproductive health problems are the leading cause morbidity, mortality for women of childbearing age worldwide, and even for infant mortality. **[Factors affecting the reproductive health:]** **[Economic factors:]** - **level of income** low income lead to decrease access to health and medical care which result in increased risk for poor health, particularly poor reproductive status. - **Lack of personal resources and opportunities:** if women, who are economically dependent upon men, are left entirely without resources of their own, this would have a negative effect on their health and nutrition. **[Social factors:]** **Denying the following rights would affect women**\'s health**:-** - Right to be informed about reproductive health. - Right of getting services. - Right to go safely through pregnancy and child birth. **[Cultural factors:]** **Gender issue:** The high value placed on sons in some regions and gender inequality leads to serious physical and psychological consequences for girls and women as it means that [men](https://en.wikipedia.org/wiki/Men) and [women](https://en.wikipedia.org/wiki/Women) are not equal and that [gender](https://en.wikipedia.org/wiki/Gender) affects an individual\'s lived experience. - **Traditional harmful practices** - **Poverty, iilliteracy** - **Lack of Nutrition Due to:** - Lack of knowledge about dietary pattern and imbalanced diet or bad eating habits might cause women to develop chronic disease as diabetes, hypertension and cardiac disease and anaemia. - Women and girls are typically the last to eat in a family; thus, if there is not enough food, they are the ones to suffer most resulting in medical conditions like anemia, malnourishment. **[Health factors:]** - Lack of health services especially in the developing countries. - Lack of trained personnel. [Age:] ------------------ Women at different ages and different stages of reproductive health have different health needs and problems. Teenage pregnancy affects the women\'s health. **[Life style and bad habits:]** - Smoking and alcohol abuse may lead to reproductive health problem like irregular ovulation and amenorrhea. **[Environmental factors:]** - Exposure to chemical substance and radiation. - Poor environmental sanitation (poor housing, poor food and water sanitation). **[Violence against women:]** - Physical violence (involve using physical force to harm or injury body). - Sexual violence. - Psychological violence includes isolating the women and humiliating or embarrassing her. **Component of reproductive health:** 1. Maternal health: is only one aspect of women's health. Further, it is prevalent not only to women in their reproductive or fertile years ( between the age of 15and 49 years ) but encompasses the entire life cycle of a women , from an infant girl to an elderly women , and it includes a range of issues related to sexual and reproductive health 2. Mental health: evidence suggests that women are more prone than men to experience anxiety, depression and somatic complaint --physical symptoms that cannot be explained medically. depression is the most common mental health problem for women and suicide is a leading cause of death for women 3. Gender based violence : women experience a range of different forms of violence but physical and sexual violence by a partner or someone else is particularly prevalent 4. Sexually transmitted infections: **[5-Family Planning ]** **Life cycle approach in reproductive health:** - **[During childhood stage:]** - Childhood (being a child) is a broad term usually applied to the phase of development in humans between infancy and adulthood. - \- Infancy (birth to 2 years old). - \- Early childhood (3 to 8 years old). - \- Middle childhood (9 to 11 years old). - **(Adolescence period) teenaged women (11-19):** - **[During adulthood stage(Maturation):]** **[Needs of girl child (birth-10yrs):]** **1- Psychological wellness** **-** The child needs a warm, caring environment to develop trust, self-esteem and self-confidence. \- Emotional support, encouragement and listening play important role in child development. **2- Nutrition\ -** It is important to meet needs of the child for growth and development. **3- Vaccination:** protect children against diseases **4- Need for health promotion and disease prevention** **5-Environmental safety:** - Children should be supervised at all times - Keep floors free of toys and obstructions that can be tripped over - Never leave babies unattended on raised surfaces **7**- **Hygiene needs** **[Problems in this period ]** - **[The risk for accident:]** - Because children are often absorbed in their own immediate interests, they can be oblivious to their surroundings. They only have a limited perception of the environment because of their lack of experience or development. They are not aware of the consequences of the many new situations that they encounter daily. - **delayed growth and development** - growth delay occurs when a child isn't growing at the normal rate for their age. The delay may be caused by an underlying health condition, such as growth hormone deficiency or hypothyroidism. In some cases, early treatment can help a child reach a normal or near-normal height. - **The risk for child abuse and neglecting:** - - **Harmful traditional practices and their effects on girl child:** **Female genital mutilation**: have health and psychological consequences such as depression anxiety bleeding infection - **[Strategies to improve girl child health :]** - The child needs a warm, caring environment to develop trust, self-esteem and self-confidence. - Emotional support, encouragement and listening play important role in child development. - It is important to meet needs of the child for growth and development. - The child Need for health promotion and disease prevention **[During adolescence stage:]** **(Adolescence period) teenaged women (11-19):** **[Needs of adolescence (young adulthood) period\ 1-Nutritional needs:]** - **[2- Education needs:]** - The increase in the education of girls contributes to greater empowerment of women. **[3- Needs for sexual and reproductive health information: ]** \- Risks and consequence of sexual activity \- Contraceptives and STIs \- Fertility issues for men and women **[4- Need for hygiene during menstruation:]** - **path regularly** take your bath at least twice a day when you are on your period. Having regular baths during your periods will help clean your private parts as well as relieve your mood. - **Change your pads regularly** change it every six hours - **Avoid soaps or vaginal hygiene products** Washing it with soap can kill the good bacteria making way for infections. - **Avoid tight-fitting clothing** This will ensure airflow around the sensitive areas as well as prevent sweating to a large extent. **[Adolescence girl problems:]** **[1-Menarche:]** Menarche usually occurs between ages 12 and 13 but may occur as early as age 9 or as late as age 18. An adolescent also may need psychological preparation for this development. Some cultures celebrate menarche, giving the adolescent special attention. **[2-Menstruation:]** The adolescent women may need information about the physiology of menstruation and external factors that may affect it, such as diet, exercise, sleep, climate changes, drug use, and stress. [**3-Early marriage**:] Early marriage increases the risk for operative delivery, low weight and malnutrition resulting from frequent pregnancies and lactation, Denial of personal development and education., Girl children undergo severe health problems like pregnancy and childbirth. **4- [Anemia:]** **5-[Violent against women]**: **6[-Depression]** Equal rates of depression between male and female pre-adolescence (11-13yrs). **[During adulthood stage (Maturation):]** - This period cover the age between 15-44. - **Needs of adulthood period of mature women;** - **Reproductive health care:** Health promotion of mother; satisfying requirements of normal pregnancy and labor, for fetal health and favorable outcome Prevention of health hazards to which the mother may be exposed during pregnancy, labor, and the postpartum period. - **Common problems during reproductive stage:** **1 --STDs :**Sexually transmitted diseases (STDs) are a major public health problem. **2-Un safe abortion :** are a leading cause of maternal mortality and can result in permanent injuries. 3**- Infertility** :is the inability to conceive a child after 12 months with regular sexual relation- without using of any contraceptive method. 4-**Contraception:** Some contraceptive methods affect women health. E.g., long-term use of oral contraceptives may increase the risk of cardiovascular disease; use of an IUD increases the risk of pelvic inflammatory disease, ectopic pregnancy. **5-Depression** \- Biological difference (reproductive, hormonal, genetic). \- Psychosocial factors (stress from working, family responsibilities and societal roles, increased rates of poverty and sexual abuse; chronic illness). **[Basic elements of reproductive health during mature stage:]** **[1- Preconception care: ]** - Preconception care is the promotion of the health and well-being of a woman and her partner before pregnancy to identify any areas such as health problems, lifestyle habits.. - **Preconception care involves:** - screening for Hereditary blood diseases, especially sickle cell disease and thalassemia. - Early detection of health problems and early treatment - Providing guidance, preparation for marriage, family education, training in the art of child rearing and family planning. - Prevention of health problems for the couple and their future children. - medical conditions, such as cardiovascular or respiratory problems and genetic disorders. **2- [Antenatal or prenatal care:- ]** It is preventive obstetric program including group of observation, medical care, investigations and advice aiming to get pregnancy, labor and postpartum as near to normal as possible. - **Objectives of antenatal care:** To reduce maternal and prenatal morbidity and mortality rates. Through: - Ensure a healthy mother and newborn. - Estimation of gestational age and expected date of delivery. - Early detection and prevention of any disease that may occur during pregnancy. - To prepare woman for labor, lactation and care of her infant. **3- [Natal care:- ]** \- It is the care that women receive during labor including: - Assessing and monitoring women during labor using the partograph. - Providing emotional and physical support through labor and childbirth. - Recognizing complications and providing appropriate management. **4- [Postnatal care:- ]** It's a comprehensive care of mother and baby start immediately after labor and extend over a period of 6 -8 week which genital organs return nearly to their pre-pregnant condition. - **Objectives of Postnatal care:** - - - Follow up and re-examination - Encourage breast feeding and proper nutrition for infants **5- [Family planning:-]** It is a program to regulate the number and spacing of children in a family through the practice of birth control. - **Objectives of family planning:** - To helps women protect themselves from unwanted pregnancies. - choose a suitable FP method, proper spacing of birth & addressing the right number of children - To improve the quality of family planning, counseling, and services. - To increase the participation and sharing of responsibility of men in family planning **Reproductive Health Services** The primary health care department provides preventive services in order to improve the health of the women through: - - Delivering reproductive health information through awareness and education programs - Providing equipment that enables early detection of reproductive system diseases (early detection of breast cancer, cervical cancer). - Encouraging pregnant women to receive a minimum of 4 visits during pregnancy and one postnatal visit. - Preparing governmental hospitals to receive emergency obstetric cases. -  Equipping governmental hospitals to receive high-risk pregnancies.   **The health services can be summarized in the following categories:** - - - - REPRODUCTIVE health RIGHTS ========================== - The right for Sexual and reproductive health, prevention and treatment services - The right for the ability to choose whether and when to get pregnant - The right for services for sexually transmitted infections and reproductive tract illnesses, - The right for access to basic health care and contraception. - The right for sexual and reproductive autonomy **Equality in reproductive health**  includes access, without discrimination, to affordable, quality contraception, including emergency contraception. as The right of a woman or girl to make autonomous decisions about her own body and reproductive functions  **[Reproductive health and gender equity and equality:]** Reproductive health services are important tools in promoting the well-being of women as well as in contributing to their empowerment. Providing family-planning, counseling, information and education to women can help in the achievement of gender equality and equity. **[Male involvement in reproductive health:]** -It is the participation and involvement of men in reproductive health programs, reproductive rights and reproductive behavior. Also it can define as: A complex process of social and behavioral changes that needed for men to play a responsible role in reproductive health. -Safe guarding women\'s health during pregnancy, child birth and post-partum. **[Top Barriers to Sexual and Reproductive Health Care in the Developing World:]** 1-Gender inequality:- Women often can't access reproductive health care because of systemic gender inequality. For instance, a woman in need of emergency obstetric care, must have her husband's permission to go to a clinic. 2-Lack of funding:- Global reproductive health is significantly underfunded. More than 200 million women want, but lack access to contraceptives. 3-Lack of skilled service providers:- In many areas, the number of service providers like doctors, nurses, and midwives is limited, and often undertrained. 4-Distance to health service point:- In rural communities, health centers, clinics, and hospitals can be far away or too difficult to reach. **[Role of the maternity nurse in Reproductive health:]** **1-Administrative role** **2-Supervisory role** **3-Educational role** **4-Research and evaluation role** **5- Sexual and Genetic counseling role** **6-Counseling role** **1-Administrative role:** Formation of policies about reproductive health. Planning of surveys of needs for information about reproductive health. Preparation in budget. Data collection. In-services education and training of nursing staff. **2-Supervisory role:** Supervision for nurses and midwifery personal. **3-Educational role:** Nurses must have knowledge about human biology of reproduction, education for family life and concept of reproductive health. The nurse must be able to transmit this knowledge effectively. **4-Role in research and evaluation:** Nurses are essential members of the research team studies. Keep careful records and reports relating to their nursing activities used in research studies. Provide valuable data upon which research may be based. Evaluation of reproductive health services. **5-Genetic and sexual counseling role:** a\) Genetic counseling may include: Provided for a client of reproductive age before conception, after conception and after birth. Genetic screening is analyzed to detect the presence of disease or case finding for couples at potential risk based on medical/family histories. b\) Sex education: Sex education may include: Risks and consequences of sexual activity. Contraceptive and sexual transmitted diseases STD\'s. **6-Counsling role:** Counseling has six elements you can remember them with the English word (GATHER): 1-(G) Great clients. 2-(A) Ask clients about themselves. 3-(T) Tel the clients about reproductive health. 4-(H) Help clients. 5- (E) Explain information. 6- (R ) Return for follow up. **[References]** +-----------------------------------------------------------------------+ | - Farré L *.,* Reproductive health, 3^rd^ ed., USA. , Jones and | | Barlett Learning com., 2014; 319-36. | | | | - Walston N., Reproductive Health, International Journal of | | Public Health , 2016; 48( 1):12-48. | | | | - BarkerJ*.,* Involving Men in Reproductive Health , UK, SAGE com., | | 2013; 240-44. | | | | - Definition of reproductive health **Retrieved from** | | | | **available at** 20-10-2019. | | | | - Sexual and reproductive health strategies **Retrieved from** | | [http://www.healthyteennetwork.org/wp-content/uploads/2016/10/ARG | | -Sexual-and-Reproductive-Health-strategies.pdf | | **available at** | | 20-10-2019](http://www.healthyteennetwork.org/wp-content/uploads/ | | 2016/10/ARG-Sexual-and-Reproductive-Health-strategies.pdf%20available | | %20at%2020-10-2019). | | | | - Indicators of reproductive health **Retrieved from** | | | | **available at** 20-10-2019. | +-----------------------------------------------------------------------+ - Adulthood **Retrieved from** https://www.cdc.gov/adulthood /docs/ 2011-508.pdf **available at** 20-10-2019. - Barrier of reproductive health retrieved from [[https://www.pathfinder.org/top-ten-barriers-sexual-reproductive-health-care-developing-world/]](https://www.pathfinder.org/top-ten-barriers-sexual-reproductive-health-care-developing-world/) available at 1/11/2020 at 11.13pm