Suchergebnisse

With the increasing labour force participation among women in Western countries, many women will work during their reproductive years. This will increase the likelihood that women during their reproductive years will be exposed to a variety of risk factors at work that may effect their reproductive abilities and the outcome of their pregnancy, such as spontaneous abortion, hypertensive disorders, intrauterine growth restriction, and adverse birth outcomes. Occupational exposures may also interact with foetal development, resulting in health effects in the offspring, such as congenital malformations and neurobehavioural disorders at young age. For several work-related risk factors the associations with reproductive effects are well established and translated into legislation, such as mandatory provisions for pregnant women preparing antineoplastic drugs or being exposed to lead. However, for many other work-related risk factors, the scientific evidence is less consistent. Work-related risk factors can be divided into chemical agents such as metals, solvents, pesticides, physical agents such as radiation and noise, and ergonomic factors such as heavy workload, shift work, and psychosocial stress.

The cascade training model has brought clinical training closer to the areas in DRC most in need of skilled staff to serve conflict-affected women experiencing complications in pregnancy and childbirth. Adapted from the source document.

Reproductive health disparities-particularly those experienced by racial and ethnic minority groups-are considered a persistent public health issue in the United States. Frameworks that focus on social determinants of health seek to identify the forces producing these disparities, particularly social conditions that create vulnerability to premature death and disease. Such frameworks pose challenges to health care provision, as structural factors can seem immutable to health care professionals trained to treat individual patients. Here, we discuss the links between reproductive health disparities and social determinants of health. We then apply to reproductive health care the structural competency framework, developed by physician-scholars to encourage health care professionals to address health disparities by analyzing and intervening upon sociopolitical forces.

Reproductive health disparities-particularly those experienced by racial and ethnic minority groups-are considered a persistent public health issue in the United States. Frameworks that focus on social determinants of health seek to identify the forces producing these disparities, particularly social conditions that create vulnerability to premature death and disease. Such frameworks pose challenges to health care provision, as structural factors can seem immutable to health care professionals trained to treat individual patients. Here, we discuss the links between reproductive health disparities and social determinants of health. We then apply to reproductive health care the structural competency framework, developed by physician-scholars to encourage health care professionals to address health disparities by analyzing and intervening upon sociopolitical forces.

The government of Burkina Faso is committed to the improvement of women's reproductive health. Within this context, the Population Council's FRONTIERS Program collaborated with two nongovernmental organizations, Tostan in Senegal and Mwangaza Action in Burkina Faso, to replicate the Tostan community-based education program. Originally developed in Senegal, this program provides modules in local languages on hygiene, problem solving, women's health, and human rights as a means of promoting community empowerment to facilitate social change. The intervention, implemented from 2000 to 2003 in the provinces of Bazega and Zoundwéogo in Burkina Faso, compared the performance of 23 participating villages with 23 control villages. To measure the program's impact on awareness, attitudes, and behavior regarding reproductive health and female genital cutting, researchers conducted pre- and post-intervention surveys of women and men in the intervention and control areas, and qualitative interviews with key community members. To measure the diffusion of knowledge, researchers surveyed men and women who lived in the intervention area but did not participate in the study. They also assessed pre-and post-intervention changes in the number of girls under 10 who had been cut.

In 2004, the Population Council's FRONTIERS Program and the Bangladesh Ministry of Youth and Sports collaborated on an intervention to introduce reproductive health education into government-run vocational-training courses. The training, offered to males and females aged 15–30, includes livestock husbandry, electronics, and secretarial work. The intervention built upon the positive results of the 1999 Bangladesh Youth Reproductive Health Study, which introduced a life-skills curriculum into secondary schools. The interactive reproductive health curriculum was modified to suit older adolescents and youth attending courses at vocational training centers. Topics included reproductive biology, family planning, pregnancy, sexually transmitted infections, critical thinking, and negotiation skills. As noted in this brief, researchers used a pre-intervention survey and two post-test questionnaires to measure the effect of training on participants' reproductive health knowledge and attitudes. Qualitative data were also obtained through focus group discussions, in-depth interviews, and discussions with students and staff. When reproductive health education was integrated with vocational training programs in Bangladesh, students' knowledge, attitudes, and life skills related to reproductive health improved.

In September 2000, the Population Council launched a nine-month project to test the effectiveness of teams of "policy champions" to increase the utilization of operations research (OR) findings in reproductive health (RH) policy and programs in the Philippines. The team members, chosen from government, nongovernment, academic, and media institutions, received three days of orientation to become policy champions. The strategy was built upon evidence that local decision-makers in decentralized health systems often have little knowledge of RH, and rarely use research findings in their decision-making. The effort focused on using a research-tested community-based monitoring and information system to help providers identify and respond to unmet need for family planning. As noted in this brief, the approach of involving teams of mobilized policy champions proved effective at influencing program managers to use a research-tested information system for identifying clients with unmet need for family planning. This approach was adopted by regional and national organizations, which plan to expand use of the management tool.

Una vez que los medios fueron liberados del control gubernamental en 1998, el mandato de los periodistas indonesios fue explorar nuevos problemas y promover el debate público. Los resultados de varios estudios demuestran que la salud de las mujeres empeoró durante 1997–99. Sin embargo, la cobertura de este problema por parte de los medios fue limitada. Para mejorar la cobertura de temas de salud reproductiva (SR) en la prensa, el Population Council llevó a cabo un proyecto de 18 meses con la colaboración del Ministerio Estatal para el Empoderamiento de la Mujer y de otros organismos clave. El proyecto se centró en mejorar los conocimientos sobre SR y las habilidades para informar de 22 periodistas de medios impresos. El personal del proyecto supervisó la cobertura de SR en 22 periódicos, revistas y tabloides importantes. Después de que los periodistas indonesios recibieron información básica y capacitación sobre temas de SR, la calidad de su cobertura mejoró. Sin embargo, como se indica en este resumen, se necesitan esfuerzos continuos para proporcionar a los representantes de los medios ideas para noticias y artículos destacados y capacitación en el uso de los resultados de la investigación. --- After government control over the media was liberalized in 1998, Indonesian journalists had a new mandate to explore new issues and foster public debate. Several studies had found evidence that women's health worsened from 1997–99, yet media coverage of this topic was limited. To increase press coverage of reproductive health (RH) topics, the Population Council conducted an 18-month media project in collaboration with the State Ministry for Women's Empowerment and other key agencies. The project focused on improving RH knowledge and reporting skills among 22 print journalists. Project staff monitored RH coverage in 22 major newspapers, magazines, and tabloids. After Indonesian journalists received background information and training on RH issues, the quality of their coverage improved. However, as noted in this brief, ...

In the late 1980s, Peru's National Family Planning Program within the Ministry of Health (MOH) assigned method-specific targets to clusters of health facilities. In 1998, the MOH changed its policies to ensure that services responded to individual reproductive health needs and wishes. It eliminated method quotas, ended voluntary surgical contraception campaigns, and issued norms to ensure quality of care and informed choice. In 1999, the Population Council collaborated with the MOH to determine whether providers were complying with the new guidelines and, secondarily, to develop a monitoring system to assess compliance over time. As concluded in this brief, family planning providers at Peru's government health facilities conform to national care guidelines in that more than 90 percent of them treat their clients respectfully and offer them a wide choice of contraceptive options. Nevertheless, it was determined that the majority of providers could further improve the quality of care by giving clients more information about correct use and possible side effects of their chosen method and by screening for contraindications.