Definition
Reproductive Health is not merely the
absence of disease or disorders of the reproductive process, rather it is a
condition in which the reproductive process is accomplished in a state of
complete physical, mental and social well being.
Fertility Regulation: Family planning. This implies
that the couples/individuals in a union make a decision concerning their
fertility either to space pregnancies as this protects the health of the mother
and infant, to prevent unwanted pregnancies as this enables couples have the
number of children at the time they can cater for the child, to secure desired
pregnancies, and thus limit family size, more so when there are health problems
and advance in age.
It also involves the treatment of infertility
to enable couples to achieve their aspirations in life.
Method used include traditional and
modern methods, behavioral practices. Some methods are self- administered while some other methods require supervision
and regular follow-up.
STI: Infertility in West African is
largely due to secondary infertility as will be discussed; An effect of
untreated or poorly treated sexually transmitted infections. Many infectious
are without symptoms particularly in the women. 60-80% of Gonococcal
infections in women are without any symptoms and as high as 40% of the males do
not have any symptoms. This makes it more difficult to seek health care.
Health seeking behaviour when there are symptoms is also a major problem as
many do not go to appropriate practitioners for treatment.
Unwanted and unplanned pregnancies: These can be as high as 40-60% in
women. Studies in Nigeria
Infertility: The inability to have children has
traditionally been a source of pain, anxiety and shame. The more importance
children are in a given society or culture, the more devastating if couples are
infertile. In Nigeria
Secondary infertility is more
widespread than primary infertility and both male and female are responsible
for the condition. With in-vitro fertilization, sperm banks, many couples who
could not have babies naturally have been able to have babies. Ethical issues
however exist.
Sexuality and safe sex: It is important that sex between
couples do not endanger their health. In other words, sex is mutual, base on
trust, single partnership and care. This may not be the case for the adolescents
who engage in pre marital sex and those who sell sex and their clients. Many
cultures permit double standard and men are to be “men”, while the women are
not to have any other partners. Double protection is advocated for women
(protect against pregnancy if not desired and protect against a sexually
transmitted infection). In addition, female condom is advocated when the males
do not cooperate to use the male condom. Health awareness programs need to be
carried out extensively for the youths and rural couples.
Child survival: Child survival lowers fertility in
any community. When couples are assured that the child will survive, they do
not try to have more children than they can possibly cope with so that at the
end of their reproductive years they have children that will survive them. Fertility
in Nigeria
Safe motherhood
Safe motherhood initiative (SMI) aims to improve maternal health by ensuring
that essential obstetric and newborn care is available to all women and newborn
who need it WHO places special
emphasis on offering guidance to governments on how they can improve maternity
services in the community and provide skilled obstetric care for high risk and
emergency cases. The 7 sponsors of SMI are WHO, World Bank, UNDP, UNFPA,
UNICEF, Population Council and International planned parenthood Federation
IPPF. This would improve maternal health and reduce morbidity and mortality in
developing countries. Each country is to develop its own modules.
Determinants of Reproductive Health
Reproductive health and health of all
in general is predetermined by
1. The socio-economic conditions in the
society.
2. It is promoted or undermined by the
individuals own lifestyle
3. By improved health care services
4. By information and technological
advances made through research
5. Culture and tradition
6. Others i.e. gender discrimination
Socio-economic class: Maternal mortality rate (MMR), Infant
mortality rate (IMR), Under 5 mortality rate (U5MR), Low birth weight (LBW) are
sensitive indicators of the level of socio-economic development in any country.
These are indirectly affected by level of education of all particularly the
girl child.
Poverty: The women and children are most
affected when there is household poverty. Poverty also limits the access to health
services and treatment
Life style and behaviour Reproductive behaviour is crucial in determining reproductive
illness which can have far reaching consequences on health especially in the
adolescent.
Improved health services and health service utilization: When health care is standard, available, affordable and
accessible for primary, secondary and tertiary prevention, reproductive health
services can be readily given.
Information and Technological Advances:
There are
many advances in the reproductive health sector to enable fertility control and
fertility.
Culture, religion and Tradition: There are many
unfavourable traditional and cultural practices which interfere with health
particularly reproductive health examples include female genital cutting, early
marriage, grand multiparity, widow inheritance, polygamy, nutritional taboos,
no education for the girl child.
Education particularly of the girls
has an important role to play in improving reproductive health in any country
and attempts should be made to ensure at least universal and free primary
education for all children in Nigeria
References
1. Okonofua F, Onwudiegwu U, Odutauo R.
Pregnancy outcome after illegal induced abortion in Nigeria African Journal of
Medicine & Medical Sciences 1994; 23 (2): 165-9
2. Oronsaye AU, Odiase GI. Attitudes
towards abortion and contraception among Nigeria
3. Odujinrin OMT. Sexual activity,
contraceptive practice and abortion amongst adolescents in Lagos
4. Adedoyin et al. pregnancy outcome
among teenage mothers in IIorin. East African Medical Journal 1989; 66 (7):
448-452.
5. Lawoyin T.O (1997). Risk factors for
Maternal Mortality. Nigerian Med. J. Vol 32; No 1:34.
6. Lawoyin T.O (1997). The relationship
between maternal weight gain in pregnancy, hemoglobin level, stature, antenatal
attendance and low birth weight. Southeast Asian J.Trop. Med. Public Health Vol
28(4): 873-876.
7. Lawoyin TO, Larsen U, Osinowo H,
Walker ME.(2001). Sexual behavioral risks of married men in Oyo State , Nigeria
8. Lawoyin TO. (2001) Risk factors for
Infant mortality in a rural African community. J of The Royal Society of
Health: 21 (2): 114-118.
9. Osibogun A. Fertility and Family size
preference I a semi urban Nigeria
National Population Commission/FGN.
ARTICLE SOURCE:
M.O. ONADEKO, MPH (Havard), M.D.
M.O. ONADEKO, MPH (Havard), M.D.
Department
of Community Medicine, College of Medicine
UCH,
Ibadan , Nigeria