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1
Foy, Robbie. "Promoting effective reproductive health care." Thesis, University of Edinburgh, 2005. http://hdl.handle.net/1842/29108.
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This thesis is concerned with approaches used by the Scottish Programme for Clinical Effectiveness in Reproductive Health (SPCERH) to improve quality of care. The work embraces two main themes: understanding factors that influence clinical practice; and evaluating strategies to improve practice. Many factors influence practice, such as the nature of targeted behaviours, professionals and organisations (Chapter 1). An observational study, of practice related to 42 audit recommendations in 16 gynaecology units, found that attributes of recommendations independently modified the effects of a national audit and feedback project (Chapter 2). Four evaluations of dissemination and implementation strategies were conducted. The first, a telephone survey of 201 obstetricians and midwives, highlighted gaps in awareness of national recommendations on the prevention of material mortality (Chapter 3). The second, a before-and-after postal survey of 92 obstetricians, found mixed changes in self-reported practice following the dissemination of four national obstetric guidelines (Chapter 4). The third, an interrupted time series analysis, evaluated trends in the care of 1263 women in four maternity units related to of these guidelines, on mild, non-proteinuric hypertension in pregnancy (Chapter 5). No improvements in the appropriateness of initial investigations and subsequent clinical management were found. The fourth study, a cluster randomised trial involving all 26 gynaecology units in Scotland, evaluated a strategy to promote a guideline on induced abortion care. The strategy, delivered under the auspices of SPCERH, comprised audit and feedback, educational meetings, dissemination of a structured case record, and promotion of patient information. The strategy was refined in the light of barriers identified following a pre-intervention case record review, interviews with gynaecologists and a theoretically-derived survey of 151 clinical staff (Chapter 6). Post-intervention compliance with guideline recommendations was assessed by a review of 1474 case records and a survey of 1028 patients. No intervention effect was observed, possibly related to high pre-intervention compliance with selected recommendations and the appropriateness of the implementation strategy (Chapter 7).
2
Tshiswaka-Kashalala, Gauthier. "Reproductive Health and Labour Outcomes." Thesis, University of Pretoria, 2014. http://hdl.handle.net/2263/45867.
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This thesis formalizes the interaction between income and fertility outcomes using a
fertility model taking account of mediation. Despite the diversity of studies concerned
with the determinants of fertility, one consistent nding is that the timing and the
number of children born to a couple are ultimately determined by the interaction
between a couple's fecundity and their contraceptive behaviour. For example, fecund
individuals may or may not be sexually active, may or may not be using contraception,
which would in
uence their degree of risk for pregnancy. In this context, fecundity
is a necessary but insu cient cause of fertility. The two variables, fecundity and
contraception, are mediator variables in the causal path between income and fertility
(Baron and Kenny, 1986). It follows that, understanding the interaction between
biological and behavioural determinants of fertility holds the key to understanding
fertility trends in any society.
With our understanding of causal-mediation in place, this thesis extends the health
investment model to develop a model of the sequential nature of the human reproductive
process. Because reproductive health is commonly understood as the capability
to procreate and the freedom to decide if, when and how often to do so, poor reproductive
health outcomes have long been acknowledged as a main cause of economic
hardship for women and their children, accounting for 18% of the total global burden
of disease and representing 32% of the burden among women of reproductive age.
Thus, the presented theoretical model of the demand for reproductive health services is a derived demand for reproductive health (with adjustment costs). Our theory
suggests that the relationship between family planning services, their marginal costs,
the stock of reproductive health capital and the woman's earnings volatility is essentially
nonlinear. The theoretical predictions arising from the model are empirically
supported from individual level South African data.
Because a number of the health costs are associated with `mistakes', in the sense
that childbearing might be ill-timed, because the reproduction process cannot be
completely controlled, at least yet, the previous model is extended to account for
uncertainty in the process. In other words, an assumption that contraception gives
women perfect control over their fertility outcomes is considered to be too simplistic.
Therefore, the focus remains on the e ectiveness of contraceptive use in controlling
fertility, but in a setting of uncertainty. The model developed ts nicely into the analysis
of the sequential nature of the human reproductive process, as it makes use of the
continuation or option value of contraception, which is assumed to depend on potential
future labor market prospects, and the uncertainty inherent in the reproduction
process. The model naturally leads to a mixed hitting time (MHT) empricial model;
a woman becomes pregnant when the underlying stochastic reproductive health process
rst crosses a threshold in zero. We nd empirical support for our theoretical
analysis.Thesis (PhD)--University of Pretoria, 2014.
tm2015
Economics
PhD
Unrestricted
3
Topelko, Katherine Mary. "The reproductive health of Guyanese women." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1998. http://www.collectionscanada.ca/obj/s4/f2/dsk2/tape17/PQDD_0006/MQ33514.pdf.
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Ragúz, María. "Sexual and reproductive health and women development from a gender perspective: The role of men." Pontificia Universidad Católica del Perú, 2013. http://repositorio.pucp.edu.pe/index/handle/123456789/101096.
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Women's health, particularly, sexual and reproductive health, and development are here approached from a gender and human rights perspective, underlying the need to address these problems from a relational and comprehensive point of view. The issue of how sexual and reproductive health is approached and the "men's as partners" strategy is discussed. Adult women-centered, female-only family planning reproduction and contraception are criticized. Gender violence eradication is stressed as an entry to sexual and reproductive health programs. The case of Peruvian urban and rural women in poverty from Amazonian and Andean communities is taken as an example. Obstacles and achievements in working with men are reviewed but a gender transversal perspective is highlighted. Finally, women's sexual and reproductive health is related to development and seen as a standpoint for addressing health.Se discute como se tratan los problemas de la salud sexual y reproductiva y el desarrollo de la mujer desde una perspectiva transversal de género y de derechos, subrayando la necesidad de trabajarlos desde una perspectiva integral. Se critican los programas y servicios centrados en la mujer adulta, en la reproducción y en la planificación familiar femenina. Asimismo, se señala la necesidad de trabajar en la erradicación de la violencia de género como una entrada para el trabajo en este ámbito. Como ejemplo, se presenta el caso de la salud sexual y reproductiva en comunidades andinas y amazónicas rurales y en extrema pobreza del Perú. Las dificultades y logros en el trabajo con hombres son analizados, subrayándose la necesidad de una perspectiva transversal de género en el trabajo. Finalmente, se relaciona la salud de la mujer con desarrollo y se concluye en la necesidad de trabajar siempre en este sentido.
5
Cornish, Julie Ann. "Inflammatory bowel disease & female reproductive health." Thesis, Imperial College London, 2011. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.539280.
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Islam, Mohammad Amirul. "Male involvement in reproductive health in Bangladesh." Thesis, University of Southampton, 2006. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.436920.
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Sunil, Thankam Sukumaran. "Reproductive Health in Yemen: A Theoretical Approach." Thesis, University of North Texas, 2002. https://digital.library.unt.edu/ark:/67531/metadc3112/.
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Several developing countries introduced family planning programs to reduce their population growth rates. The rapid spread of birth control programs in the developing countries was at times accompanied by measures which violated human rights. In response to the ethical violations and coercive policies on population control, toward the end of 1980s various international committees formulated a reproductive health approach to overcome the limited population control approach. Unlike other population control programs, the focus of reproductive health program is on “reproductive process,” where as the most immediate focus of family planning programs is on fertility. Although studies refer to reproductive health approach as an extension of fertility control approach, literature on reproductive health provides very few systematic approaches toward developing explanations of reproductive health. The current approaches on population control are influenced by the ideological shift towards a broad-based approach which involves fertility or family size as one of the components of reproductive health. The present study uses intermediate variables framework suggested by Davis and Blake to organize reproductive health explanations. The proposed framework suggests that the state of reproductive health is indicated by intercourse, conception, and gestation variables and assumes that reproductive health is a latent dimensional outcome indicated by the measures of the intermediate variables. Also, there is noticeable lack of studies on reproductive health in Muslim countries. Given this shortcoming in the literature on reproductive health, the proposed model on reproductive health is used to assess the reproductive health of women in Yemen. The data are from the Yemen Demographic and Maternal and Child Health Survey (YDMCHS) conducted in 1997. Structural equation analysis is used to analyze the data. It is found that gender power or women's empowerment is more influential than economic status in determining reproductive health outcomes. The results of the study provide support for the proposed model. Implications for social policy making are discussed.
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Goel, Hersh Vivek. "Adolescent's Reproductive Health Knowledge in Dehli, India." Thesis, The University of Arizona, 2010. http://hdl.handle.net/10150/146834.
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Impoverished adolescents in India, especially children of sex workers, are a highly vulnerable population that is at risk of being infected with HIV/AIDS. In order to protect their reproductive health status, their knowledge of sexual health must be investigated. This study analyzed the data from a survey of 106 men and women that attended ASSET/Swabhiman supplemental education classes in Delhi, India. Results indicated that reproductive health knowledge among this population is satisfactory but lacking in certain areas. Survey participants demonstrated adequate knowledge of sexually transmitted infections (STIs); however, they were much less knowledgeable about contraceptive measures. Among those surveyed, 78.2% thought that condoms were very effective or somewhat effective in preventing HIV/AIDS while 67.6% did not know what pulling out was or they thought it was a "safer" form of sex. Only 55.2% said they had learned about HIV/AIDS in school while 72.6% said they knew nothing at all, only a little, or some about STIs. The need for reproductive health education among this population is imperative and it must be made a focus of supplemental education programs.
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Ozden, Asli. "Can Reproductive Health Program Empower Women? A Feminist Post-development Critique Of European Union Funded Reproductrive Health Program In Turkey." Master's thesis, METU, 2010. http://etd.lib.metu.edu.tr/upload/3/12612107/index.pdf.
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Whithin the recent human centered development approach, the mission of development's declared aims are alleviating poverty, increasing choices by reducing '
risks'
and empowering women. In line with the human development framework, Reproductive Health program aims at improving women'
s health, enlarging women'
s chices and engendering reproductive rights. The scope of '
empowerment'
is conceptualized as strenthening their capabilities to prevent sexual reproductive health risks, thereby enlarging their reproductive choices whithout reflecting on the role of general political economic structures. this thesis argues that while general health indicators and life choices and rights of poor women are decreasing due to neoliberal shrinkage of social policy and flexible working regimes, the sole focus on reproductive health and rights by development agents is irrelevant. In line with this argument, this study draws upon post-development theory in order to argue that development is a historically specific representation of social reality which permits particular modes of knowing while disqualifying others for perpetuating gobal hegemonic regimes.
10
Pacheco, Christy Lee. "Program Evaluation of a County Reproductive Health Program." Diss., The University of Arizona, 2012. http://hdl.handle.net/10150/228158.
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Northern Arizona women of childbearing age are at disproportionately higher risk for poverty and persistent health disparities in maternal risk factors and maternal child health outcomes. Preconception care is a lifespan and population-based approach to providing health promotion activities to women of childbearing age to improve the health of women, their families, and communities. The county's Reproductive Health Program offers comprehensive reproductive and preconception healthcare to underserved women and men throughout the county without regard for ability to pay, serving as a critical safety net for this vulnerable population. A formative evaluation was performed using the CDC's Framework for Program Evaluation in Public Health and retrospective chart review to assess program implementation. In 2010, 1,561 patients received care over 2,575 visits; the majority of patients (69.4%) were women of childbearing age (females 15-44). Most patients (92.9%) were ≤ 150% FPL, and uninsured (77.8%). Program patients were racially/ethnically diverse, with nearly half identifying themselves as White (48.8%), followed by Hispanic (35.3%), and American Indian/Alaskan Native (11.6%). Program reach was limited. Comprehensive medical and social risk assessment and health promotion activities were consistent with evidence-based recommendations. More than 3,400 STI and pap screenings were performed, with identification of 178 abnormal results at the primary program site. One hundred forty-five females had a positive pregnancy test at the primary program site, one-third (33.1%) to teens. For women of childbearing age not trying to become pregnant (98%), a range of family planning methods were provided, which most commonly included oral contraception (36.9%), followed by condoms (15.4%), and Depo-Provera injection (12.6%). More than 10% of low-income females 15-44 received referrals for further medical care not provided with program. Logistic regression analysis revealed program visits associated with a decreased risk of unplanned pregnancy, though this was not significant (OR 0.87, 95% CI 0.59-1.29, p>0.05). In conclusion, this program provided evidence-based preconception care to underserved women of childbearing age, though reach was limited. Additional studies are recommended to explore patient needs and barriers to improve reach and tailor services. Development of a community advisory council is recommended to guide program activities.
11
Yalahow, Abdiasis. "Exploring the Reproductive Health Education of Health Service Professionals in Mogadishu, Somalia." Thesis, Université d'Ottawa / University of Ottawa, 2017. http://hdl.handle.net/10393/36709.
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Somalia has recently come out of a two decade long civil war and is currently in a post-war and rebuilding phase. The national health system, largely crippled during years of conflict, is faced with a significant maternal mortality ratio and the debilitating effects of a high fertility rate. To combat these issues, the new Somali government is working toward creating a strong national health system that addresses some of these key indicators. With a lack of human resources in healthcare and the need for better reproductive health services, the need to invest in educating a new generation of health service professionals is evident. To address this gap in education, many educational institutions with health science faculties have opened in the last decade but the quality and accuracy of their curricula has yet to be examined. My thesis addresses this gap in knowledge. Through a multi-methods study that included reviewing curricula and curricular materials, conducting key informant interviews, and facilitating focus group discussions, I was able to learn about the quality and comprehensiveness of reproductive health topics in health service professionals‟ education and training. Religion, culture, logistical issues, and lack of oversight shape the way reproductive health is taught to health students. This study provides an important foundation to help inform key stakeholders working to improve the Somali health system.
12
Gallipeau, Sherrie. "Altered Reproductive Function and Amphibian Declines." Thesis, University of California, Berkeley, 2014. http://pqdtopen.proquest.com/#viewpdf?dispub=3640434.
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Agrochemical exposure is one of the factors that contributes to worldwide amphibian declines. Most studies that examine agrochemicals and amphibian declines focus on toxicity. However, declines are more likely caused by the sub-lethal effects of agrochemical exposure. Past emphases on the lethal effects of agrochemical exposure have overshadowed the contribution of decreased recruitment in amphibian declines. Additionally, studies that examine agrochemicals and reproductive function tend to focus on the effects of single chemical exposures instead of the effects of ecologically relevant mixtures. To address these issues, this dissertation examined the effects of ecologically relevant agrochemical exposures on the stress response and the reproductive endocrinology, morphology, and behaviors of male amphibians in the laboratory and the wild.
Chapter 1 provides a general review of the factors implicated in amphibian declines and provides an overview of the previous research conducted on the effects of agrochemical exposure on recruitment.
Chapter 2 is a field study that examined whether agricultural run-off alters the stress response and reproductive function of male bullfrogs ( Lithobates catesbeianus). Bullfrogs were collected upstream and downstream of agricultural activity across three California river systems (Salinas, Sacramento and San Joaquin). Size, primary and secondary sex traits, sperm count, and corticosterone and testosterone levels were examined. Overall, bullfrogs living downstream of agricultural activity (i.e. exposure to agricultural run-off) were small and had elevated testosterone and corticosterone levels. In addition, downstream males from the Salinas and San Joaquin Rivers were also small in size and had elevated testosterone levels. However, only downstream males of the San Joaquin River had elevated corticosterone and exaggerated secondary sex traits. Together, these data suggest that living downstream of agriculture can alter size, hormone levels, and the expression of sexually dimorphic sex traits. Such changes to the reproductive endocrinology and morphology of male amphibians can be detrimental to the reproductive health and long-term reproductive success of amphibian populations.
In Chapter 3, I examined corticosterone, testosterone, and the reproductive clasping behaviors of adult male African clawed frogs (Xenopus laevis) exposed to field collected and simulated agricultural run-off. This experiment implemented a novel eco-relevant experimental design to mimic real-life agrochemical exposures. Male frogs were exposed to field water collected downstream (agricultural run-off) and upstream (negative control) of agricultural activity along the Salinas River, CA. In addition, a pesticide mixture containing the top agrochemicals used in the Monterey County was included to simulate agricultural run-off. Mating behavior was suppressed in males exposed to simulated agricultural run-off but enhanced in males exposed to field collected agricultural run-off. In addition, testosterone levels of clasping males were elevated in comparison to controls. Males immersed in simulated agricultural run-off had significantly lower testosterone levels than control males in 2010. These data suggest that agrochemical exposure (both field collected and simulated) can alter reproductive hormones and clasping behaviors. Altered sex hormones and behaviors in male amphibians may play a role in amphibian declines.
Lastly, this dissertation is summarized in Chapter 4. The applicability of this dissertation as a model for amphibian declines and other reproductive related human health concerns are also introduced.
13
Rokicki, Slawa. "Improving Reproductive Health: Assessing Determinants and Measuring Policy Impacts." Thesis, Harvard University, 2016. http://nrs.harvard.edu/urn-3:HUL.InstRepos:33493534.
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In this thesis, I investigate policies and programs to improve reproductive health. My thesis makes a substantive contribution to reproductive health policy and a methodological contribution to quasi-experimental research.
In chapter 1, I evaluate the impact of a mobile phone intervention for adolescent girls. I design and implement a randomized controlled trial in Ghana to test whether sending information via mobile phones is an effective way to improve girls’ knowledge of sexual health and to ultimately reduce teenage pregnancy. I find that mobile phone programs are effective not only in increasing knowledge, but also in decreasing risk of pregnancy among sexually active adolescents. I discuss the results in the context of sexual education policy in Ghana.
In chapter 2, I explore the complex interactions between migration and reproductive health. I reconstruct the complete migration and reproductive health histories of women residing in the urban slums of Accra, Ghana. Using individual fixed effects to reduce selection bias, I find an increased risk of pregnancy, miscarriage, and abortion in the 48 months after migration, with no significant increase in the chance of live birth during this time period. With half of abortions in Ghana classified as unsafe, these results suggest that policies which target the rapidly growing number of urban migrants by providing access to contraception and public hospital services may reduce unsafe abortion and improve maternal health outcomes.
In chapter 3, I investigate the bias of standard errors in difference-in-difference estimation, which typically evaluates the effect of a group-level intervention on individual data. Common modeling adjustments for grouped data, such as cluster-robust standard errors, are biased when the number of clusters is small. I run Monte Carlo simulations to investigate both the coverage and power of a wide variety of modeling solutions from the econometric and biostatistics fields, while varying the balance of cluster sizes, the degree of error correlation, and the proportion of treated clusters. I then apply my results to re-evaluate a recently published study on the effect of emergency contraception on adolescent sexual behavior. I find that the study’s results claiming that emergency contraception increases risky sexual behavior may be spurious once proper adjustments for grouped data are applied.Health Policy
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Spring, Marline Ann. "Reproductive health and fertility of Hmong immigrants in Minnesota. /." ON-CAMPUS Access For University of Minnesota, Twin Cities Click on "Connect to Digital Dissertations", 2001. http://www.lib.umn.edu/articles/proquest.phtml.
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Yakong, Vida Nyagre. "Rural Ghanaian women's experience of seeking reproductive health care." Thesis, University of British Columbia, 2008. http://hdl.handle.net/2429/3805.
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Ghana, a low-income developing country in sub-Saharan Africa is experiencing low
maternal health service utilization and high rates of maternal mortality, especially in the rural
areas. The Talensi-Nabdam District is one of the poorest and most remote districts in Ghana. The
reproductive health status of women in the most remote communities in this District is poor.
Dialogue about women’s reproductive health care needs in Ghana have been influenced by
health care authorities, professionals, researchers and experts’ perceptions.
The purpose of this ethnographic research was to explore rural Ghanaian women’s
experiences of seeking reproductive health care from their own perspectives. The study was
based on data collected from participant observations, unstructured face-to-face interviews and
focus group discussions. A total of 27 women of varying socio-demographic backgrounds
participated in the study.
Interviews were conducted at locations of the women’s choice and in women’s local
dialect. Data were translated and transcribed verbatim, and analyzed thematically. Four major
themes emerged from the findings: submitting to the voices of family, women’s experiences of
receiving nursing care, the community of gossip, and gaining voice.
The findings of this study have implications for nursing practice, education and nursing
inquiry. Awareness of barriers that rural women encounter in meeting their reproductive health
care needs among health care providers is important in facilitating positive health care seeking
behaviours. Nurse educators should orient themselves to the challenges to meeting women’s
health care needs, and include in culturally sensitive approaches in nursing education programs.
Further research is needed to investigate strategies that will enhance women’s
reproductive health care seeking behaviours in rural settings and to focus on women’s
perspectives in particular. In addition, research is needed to examine nurses’ perspectives on
factors that influence quality care delivery to address women’s reproductive health issues.
16
Presern, Carole Bridget. "Reproductive health care in poor urban areas of Nepal." Thesis, University of London, 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.243545.
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Richiello, Isabella. "Women's experience of a sexual and reproductive health chatbot." Thesis, KTH, Medieteknik och interaktionsdesign, MID, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-231819.
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Chatbots are increasing in popularity and interacting with humans via written language. Previous research has looked at chatbots within several domains, but not towards women’s general sexual and reproductive health. This offers a need to extend the small body of current research. This report aimed to do so by describing women’s experiences of a sexual and reproductive health chatbot used as a decision support tool. The chatbot was designed based on a user-centered approach, allowing women to express desired personality traits in a person when discussing the topic. This resulted in the design creation of two chatbots with two different personalities. Exploratory Wizard of Oz studies were conducted with 6 users by simulating interaction with both chatbots operated by a human. Users were followed up with a survey and interview creating insights to their experiences with each chatbot. Findings resulted in contributing to research with proposed guidelines for how to design a sexual and reproductive health chatbot.Chatbots blir allt mer populära och interagerar med människor genom skriftligt språk. Tidigare forskning har utforskat olika användningsområden för chatbots, men kvinnors sexuella och reproduktiva hälsa har inte varit en av dessa områden. Detta skapar ett behov att expandera den nuvarande smala forskningen. Denna studie syftar till att göra det genom att beskriva kvinnors erfarenheter av en chatbot för sexuell och reproduktiv hälsa som används som ett beslutsstödsverktyg. Chatboten utformades utifrån ett användarcentrerat tillvägagångssätt, vilket tillät kvinnor att uttrycka önskade personlighetsdrag hos en person som man diskuterar ämnet med. Detta resulterade i ett design skapade av två chatbots med två olika personligheter. Wizard of Oz studier genomfördes med 6 användare genom att simulera interaktionen med båda chatbots drivna av en människa. Deltagarna följdes upp med en enkät, följt av en intervju för bättre insikt till deras erfarenhet med varje chatbot. Resultaten resulterade i att bidra till forskning med förslag på riktlinjer för hur man utformar en chatbot för sexuell och reproduktiv hälsa.
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Darbha, Subrahmanyam. "Reproductive Health Trends In Female Sex Workers In Madagascar." The Ohio State University, 2011. http://rave.ohiolink.edu/etdc/view?acc_num=osu1309360596.
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Upton, Dannielle Heather. "Follicle stimulating hormone: ovarian reproductive function, health and aging." Thesis, The University of Sydney, 2016. http://hdl.handle.net/2123/15845.
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Follicle stimulating hormone (FSH) is vital for ovarian function; however elevated circulating levels are associated with reproductive ageing and ovarian tumorigenesis in women. Transgenic FSH (TgFSH) mice developed in our laboratory exhibit progressively rising FSH levels with ageing, causing ovarian dysfunction and premature infertility but no ovarian tumours. We hypothesized that high FSH may decrease oocyte developmental competence and quality with age and may also promote ovarian tumorigenesis when combined with ovarian mutations (such as in Pten, Brca1 and Trp53) in mice. Our first study examined the effects of elevated FSH on oocyte developmental capacity and quality (Chapter 3). Follicle stimulating hormone is vital for ovarian function and serum FSH increases with age as ovarian function declines towards menopause. We hypothesize that elevated FSH may rescue follicles from a diminishing pool normally excluded from selection, thereby reducing oocyte function. TgFSH mice expressing progressively rising FSH levels with age displayed increased litter size initially but after 6 months of age exhibited decreased litter size and premature infertility due to increased embryo-foetal resorption; however, the specific mechanism was undefined. We hypothesized that premature infertility observed was due to increased circulating FSH exceeding a threshold thereby impairing oocyte development and functionality. We examined oocyte in vitro maturation and aneuploidy and cumulus cells (from cumulus-oocyte complexes) for gene expression analysis in TgFSH and non-TgFSH control mice aged 6, 12, 18 and 24 months. Oocytes of TgFSH mice exhibited an increased percentage of cells remaining at the germinal vesicle (GV) stage, accompanied by a reduction in oocytes at the meiosis II (MII) stage of maturation vs age-matched littermate controls. The reduced oocyte progression to the MII stage is attributable to stalling of the oocytes in the GV stage. The proportion of aneuploid oocytes increased with age but did not differ between genotypes. We also wanted to examine cumulus cells matched to aneuploidy analysed oocytes for potential biomarkers of oocyte quality. A panel of 12 different candidate genes (Has2, Inhba, Egfr, Grem1, Tnfaip6, Ptgs2, Cyp19, Serpine2, Pgk1, Rgs2, Ctnnd2, Cxcr4) were examined by gene expression analysis utilising aneuploidy analysed oocyte matched cumulus cells revealing three potential markers (Egfr, Inhba, Rgs2) of oocyte quality.
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Lui, Paraniala Silas Celebi. "Reproductive health problems faced by men in Solomon Islands." Thesis, Queensland University of Technology, 2016. https://eprints.qut.edu.au/101163/1/Paraniala%20Silas%20Celebi_Lui_Thesis.pdf.
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This study is one of few to examine reproductive health problems affecting men in the Pacific region. Four hundred men in Honiara suburbs were interviewed about their reproductive and sexual problems and their general health. Disorders of sexual function were reported by many men in the Solomon islands, and were associated with common chronic diseases and poor mental health. However, levels of help-seeking, medical screening and treatment were low. The study recommends development of culturally sensitive reproductive health care for men in Pacific Island nations and territories.
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Oskorouchi, Hamid R. "Health and Fertility among Afghan Women of Reproductive Age." Doctoral thesis, Università degli studi di Trento, 2018. https://hdl.handle.net/11572/368978.
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Chapter II:
No extant study addresses the persistent detrimental effect of in utero exposure to conflict in countries experiencing protracted conflict. I therefore estimate the impact of in utero conflict exposure on weight-for-age z-score (WAZ) by applying instrumental variable regression to information on Afghan children aged 0-59 months merged with data on district-level fatalities during the intrauterine period. Although like previous research, I find an overall negative effect of violence on WAZ, the effect is stronger for children born in districts where long-term conflict is on average comparatively lower. I attribute these heterogeneous effects to the fact that households living in environments of constant conflict have developed more effective coping strategies. I support this result by showing that physical insecurity in districts in which opium poppy is cultivated, a coping strategy for rural farmers, has a comparatively smaller negative effect on household wealth because of the lower risk of eradication.
Chapter III:
Although Afghanistan experienced a slight rise in female literacy and some decline in female and infant mortality between 2000 and 2015, these improvements were not great enough to explain the simultaneous dramatic drop in total fertility, from 7.5 to 4.6. In this study, therefore, I test the previously unverified hypothesis that long-term conflict has a negative causal impact on both fertility outcomes and fertility preferences. More specifically, by applying 2SRI GLM Poisson regressions to cross-sectional data for a subsample of ever-married women of reproductive age (15-49)
combined with georeferenced information on district level conflict from 1979 to 2015, I estimate the causal impact on fertility of conflict experienced since the time of first union. I find that although long-term conflict does indeed reduce the number of pregnancies and living children, when a woman’s ideal number of children desired over the lifetime is used as the dependent variable, conflict is a relatively small (albeit still statistically significant) determinant of fertility preferences. This finding implies that, given the only modest improvements in women’s health and development, the drop in Afghanistan’s total fertility rate would slow down if the conflict were to cease.
Chapter IV (a joint work with Peng Nie and Alfonso Sousa-Poza):
This study uses biomarker information from the 2013 National Nutrition Survey Afghanistan and satellite precipitation driven modeling results from the Global Flood Monitoring System to analyze how floods affect the probability of anemia in Afghan women of reproductive age (15–49). In addition to establishing a causal relation between the two by exploiting the quasi-random variation of floods in different districts and periods, the analysis demonstrates that floods have a significant positive effect on the probability of anemia through two possible transmission mechanisms. The first is a significant effect on inflammation, probably related to water borne diseases carried by unsafe drinking water, and the second is a significant negative effect on retinol concentrations. Because the effect of floods on anemia remains significant even after we control for anemia’s most common causes, we argue that the condition may also be affected by elevated levels of psychological stress.
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Oskorouchi, Hamid R. "Health and Fertility among Afghan Women of Reproductive Age." Doctoral thesis, University of Trento, 2018. http://eprints-phd.biblio.unitn.it/2883/1/OskorouchiPhDThesis_01_2018.pdf.
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Chapter II:
No extant study addresses the persistent detrimental effect of in utero exposure to conflict in countries experiencing
protracted conflict. I therefore estimate the impact of in utero conflict exposure on weight-for-age z-score (WAZ) by
applying instrumental variable regression to information on Afghan children aged 0-59 months merged with data on
district-level fatalities during the intrauterine period. Although like previous research, I find an overall negative effect of violence on WAZ, the effect is stronger for children born in districts where long-term conflict is on average comparatively lower. I attribute these heterogeneous effects to the fact that households living in environments of constant conflict have developed more effective coping strategies. I support this result by showing that physical insecurity in districts in which opium poppy is cultivated, a coping strategy for rural farmers, has a comparatively smaller negative effect on household wealth because of the lower risk of eradication.
Chapter III:
Although Afghanistan experienced a slight rise in female literacy and some decline in female and infant mortality
between 2000 and 2015, these improvements were not great enough to explain the simultaneous dramatic drop in total
fertility, from 7.5 to 4.6. In this study, therefore, I test the previously unverified hypothesis that long-term conflict
has a negative causal impact on both fertility outcomes and fertility preferences. More specifically, by applying 2SRI
GLM Poisson regressions to cross-sectional data for a subsample of ever-married women of reproductive age (15-49)
combined with georeferenced information on district level conflict from 1979 to 2015, I estimate the causal impact on
fertility of conflict experienced since the time of first union. I find that although long-term conflict does indeed reduce the number of pregnancies and living children, when a woman’s ideal number of children desired over the lifetime is used as the dependent variable, conflict is a relatively small (albeit still statistically significant) determinant of fertility preferences. This finding implies that, given the only modest improvements in women’s health and development, the drop in Afghanistan’s total fertility rate would slow down if the conflict were to cease.
Chapter IV:
This study uses biomarker information from the 2013 National Nutrition Survey Afghanistan and satellite precipitation driven modeling results from the Global Flood Monitoring System to analyze how floods affect the probability of
anemia in Afghan women of reproductive age (15–49). In addition to establishing a causal relation between the two by exploiting the quasi-random variation of floods in different districts and periods, the analysis demonstrates that floods have a significant positive effect on the probability of anemia through two possible transmission mechanisms. The first is a significant effect on inflammation, probably related to water borne diseases carried by unsafe drinking water, and the
second is a significant negative effect on retinol concentrations. Because the effect of floods on anemia remains significant even after we control for anemia’s most common causes, we argue that the condition may also be affected by elevated levels of psychological stress.
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Forsyth, Patricia Eileen. "Investigating the reproductive health knowledge, attitudes and practices among student nurses at a selected private nursing college in South Africa." University of the Western Cape, 2018. http://hdl.handle.net/11394/6865.
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Magister Curationis - MCurBackground: The changes in sexual and reproductive behaviour of young people as they become students, has been widely documented. International and local studies promote the development of student-centred, comprehensive and accessible reproductive health services. In order to establish effective reproductive health care within education institutions, it is strongly recommended that one should understand the local context well. Aim: This study aimed to describe the reproductive health knowledge, attitudes and practices of student nurses at a select private nursing college in South Africa.
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Kashyap, Sonya. "Assisted reproductive medicine: Systematic reviews and randomized controlled trials." Thesis, University of Ottawa (Canada), 2005. http://hdl.handle.net/10393/26940.
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The objective for this thesis was to propose a question in the area of reproductive medicine that could be addressed by a clinical trial. In preparation for such a trial we conducted a systematic review of the topic.
Our first question was whether metformin is of benefit compared to clomiphene citrate for ovulation induction and achievement of pregnancy in women with polycystic ovarian syndrome (PCOS). We conducted a systematic review (SR) and meta-analysis of the subject before designing and implementing a randomized controlled trial (RCT). The RCT was terminated for recruitment issues. Our PCOS SR led us to develop a novel ovarian stimulation protocol for poor responders. We used the lessons learned from our failed RCT and another systematic review to design and conduct a feasibility randomized controlled trial on the use of aromatase inhibitors to improve pregnancy outcomes for in-vitro fertilization in poor responders. We successfully completed the pilot study and found a trend towards increased clinical pregnancy rates for patients who received the study versus the standard protocol. The pilot study provides recommendations for the definitive trial.
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Ahmed, Misbah Uddin Pimonpan Isarabhakdi. "Married female adolescents' reproductive health behavior in Bangladesh : evidence from Demography and Health Survey /." Abstract, 2006. http://mulinet3.li.mahidol.ac.th/thesis/2549/cd393/4838752.pdf.
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Bath, Louise E. "The reproductive health of women treated for cancer in childhood." Thesis, University of Edinburgh, 2005. http://hdl.handle.net/1842/24986.
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This thesis addresses aspects of hypothalamic, pituitary, ovarian and uterine function in post pubertal women following treatment for cancer in childhood. The effect of low dose cranial irradiation (18-24 Gray) on gonadal function was evaluated in long-term survivors of childhood leukaemia. Tracking of urine luteinising hormone (LH), oestrone and pregnandiol demonstrated reduced LH secretion throughout the cycle and particularly during the LH surge, short luteal phases and decreased oestrone production. These data indicate that treatment for childhood leukaemia results in a subtle ovulatory disorder in some patients, probably related to cranial irradiation. Women treated for childhood cancer, who have progressed spontaneously through puberty and have regular menstrual cycles, may still be at risk of an early menopause. Ovarian reserve was assessed in women with regular menstrual cycles and women with a history of regular cycles who were using the oral contraceptive pill (OCP), for contraception. They were investigated before and 24 hours after an injection of follicle stimulating hormone (FSH). Women with regular cycles had significantly higher basal FSH, and lower anti-Mullerian hormone levels, and reduced ovarian volume. Women on the OCP had a reduced inhibin B response to FSH and lower antral follicle counts. Therefore, both groups showed hormonal and biophysical evidence of partial loss of ovarian reserve. Radiotherapy to the abdomen carries a high risk of ovarian failure. The effect on the uterus is less well documented. Ovarian and uterine function were evaluated in women who had received total body irradiation in childhood (14.4 Gray). In women with ovarian failure, uterine function was evaluated before and after 3 months of physiological sex steroid replacement (pSSR). At baseline, uterine artery blood flow and thickening of the endometrial were not detectable. After 3 months of pSSR neither blood flow or endometrial thickness were different from controls. Uterine volume remained smaller, and there was a correlation with age at irradiation. Endometrial samples were obtained and the histology and histochemistry of the endometrium were normal compared with controls. Hormone replacement therapy and achieves physiological sex steroid concentrations improves uterine size, blood flow and endometrial development. For those young women that have ovarian failure there is no good evidence as to the optical method of pubertal induction and subsequent cyclical hormone replacement therapy. UK practice was evaluated by postal questionnaire sent to all British Endocrinologists who were members of the European Society for Paediatric Endocrinology.
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Sheehy, Grace. "A Reproductive Health Needs Assessment in Peri-Urban Yangon, Myanmar." Thesis, Université d'Ottawa / University of Ottawa, 2015. http://hdl.handle.net/10393/32785.
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The 2010 elections in Myanmar installed the country’s first civilian-elected government in more than 50 years, and subsequent growth and change have been rapid. However, reproductive health indicators are generally poor and reflect significant regional and geographic disparities. Rural populations are increasingly migrating to urban centers, like Yangon, in search of better economic opportunities and in response to persistent conflict. Many are settling in peri-urban Yangon, a dynamic series of townships characterized by poor infrastructure, slums, and a highly mobile population. However, very little is known about the reproductive health needs of this population. This study was designed to identify the reproductive health needs of women in peri-urban Yangon, and to understand better current practices, available services, and potential avenues for improvement. My research focused on delivery care, contraception, abortion, and post-abortion care. Using a multi-methods approach, and standard qualitative analytic techniques, I identified significant unmet reproductive health needs in peri-urban Yangon. The findings suggest that reproductive health services are often available but inaccessible. Findings demonstrate considerable misinformation, common and unsafe practices surrounding abortion and delivery, and a dearth of comprehensive sexual and reproductive health services for adolescent and unmarried populations.
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Farragher, Tracey Marie. "Spatial epidemiology of indicators of male reproductive health in Scotland." Thesis, University of Edinburgh, 2005. http://hdl.handle.net/1842/29096.
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Objectives: (i) Describe the geographical distributions of three indicators of male reproductive health in Scotland (i.e. testicular cancer, cryptorchidism and hypospadias); (ii) Describe the conjoint geographical distribution of the three indicators specified in (i); and (iii) Identify explanatory factors that might account for the geographical distribution of male reproductive health in Scotland. Methods: An epidemiology study modelling the geographical distributions using routinely collected data of the three indicators. Results: There are similarities in the spatial pattern of the cryptorchidism and hypospadias relative risks, with both conditions having clusters of high relative risks in the East and South-West of Scotland. The spatial variation of the testicular cancer relative risks is not similar to the other two conditions nor is it conclusive that it, has a distinct spatial pattern. The relative risks of the postcode sectors for all the indicators are associated with radon measurements and the rural/urban indicator. The spatial analysis of individual information concerning the cryptorchidism cases indicate that the spatial variation of the relative risks might also be explained by individual information; namely maternal age and co-morbidity with hypospadias. Conclusions; There does appear to be geographically varying risk factors associated with these three conditions. Furthermore, as the spatial variation of cryptorchidism and hypospadias is similar it is likely that they have some common aetiology. As the same risk factors were found to be associated with testicular cancer and the congenital malformations, then this carcinoma appears to share some aetiology with cryptorchidism and hypospadias. Therefore there are geographically varying risk factors whose exposure occurs in utero, that are associated with all three conditions, providing some evidence to support the proposed hypothesis. Further studies are required to investigate the associations between all the disease/conditions of male reproductive health and the various potential risk factors.
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Gupta, Vaibhav. "Reproductive and child health service delivery and utilization in India." CONNECT TO ELECTRONIC THESIS, 2007. http://dspace.wrlc.org/handle/1961/4164.
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Begum, Farhana. "Women's reproductive illnesses and health seeking in a Bangladeshi village." Thesis, University of British Columbia, 2012. http://hdl.handle.net/2429/42492.
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This dissertation explores women’s health seeking behaviors during reproductive complications in rural Bangladesh drawing on Bourdieu’s Theory of Practice. Based on a year of ethnographic fieldwork in a northern village of the country, where four types of health care services—biomedicine, homeopathy, kabiraji (ayurveda), and folk treatment—are available, it explores how women define illnesses and seek therapies for reproductive health. It shows that women’s health seeking and obtaining health services are influenced by their authoritative knowledge, cultural practices, therapy management groups, kin networks, household economics, education, and gender inequality.
In the case of reproductive complications, women first try to understand the nature and causes of the problem based on their cultural knowledge. They categorize illnesses into four categories—osukh, dushi, jadu, and gojob—with the help of their therapy management groups. The women with high economic, cultural, and social capital are more likely to categorize reproductive complications as cases of osukh and lean toward seeking biomedical treatment while the women with low economic, social, and cultural capital are more likely to categorize illnesses as cases of dushi or jadu and lean toward seeking folk healers.
When an illness is a case of dushi, jadu, or gojob, women prefer a folk healer for treatment. The women with high economic, cultural, and social capital prefer a folk healer of their same status while the women with low economic, cultural, and social capital prefer a healer who is “reliable” and “accessible”. When an illness is a case of osukh, women can seek biomedicine, homeopathy, or kabiraji for treatment. The women with low economic, social, and cultural capital first pursue cheaper options like kabiraji and homeopathy, and seek biomedicine when these options fail to cure the disease. On the contrary, the use of biomedicine by women with high economic, cultural, and social capital is influenced by their therapy management groups, household priorities, and the social capital of their households. This dissertation contributes to the area of anthropology of women’s health that highlights women’s subjectivity, their gendered access to forms of symbolic capital, and the role of authoritative knowledge in health seeking.
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Schoeman, Jeanne. "Violence against women : impact on reproductive health and pregnancy outcome." Thesis, Stellenbosch : Stellenbosch University, 2003. http://hdl.handle.net/10019.1/53713.
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Thesis (MSc)--Stellenbosch University, 2003.ENGLISH ABSTRACT: Introduction Worldwide, up to 25% of women are assaulted during pregnancy, with estimates varying between populations. Violence has been associated with adverse pregnancy outcome, including preterm birth, abruptio placentae and low birth weight. Among the Coloured population of the Western Cape the incidence of spontaneous preterm birth is 20%, compared to the global figure of 10%. Overall, the rate of preterm labour has not dropped over the past 40 years and no clearer answer as to a specific cause has been found. The objective of this study was to determine whether patients who deliver preterm experience more domestic violence than those who deliver at term. Methods Two groups of patients were assessed. Firstly, patients who spontaneously delivered between 24 and 33 weeks (24wOd - 33w6d), who were admitted for suppression of active labour after 24 weeks, or who experienced placental abruption before 34 weeks, were screened for domestic violence using the "Abuse Assessment Screen". A second group of women, attending a local Midwife Obstetric Unit with uncomplicated pregnancies, completed the same questionnaire. The questionnaires were all administered by the same person (J.S.) after written informed consent was given. Results A total of 229 patients were interviewed, 99 in the low risk (LR) and 130 in the preterm labour (PTL) group, which included 23 women with abruptio placentae. The PTL group experienced significantly more violence throughout their lives than the LR group (59.7% vs. 40.4%, p = 0.038). Experiences of violence within the last year or during the pregnancy did not reach statistical significance between the two groups, although the numbers were higher for the PTL group. The PTL group smoked significantly more cigarettes per day (p = 0.009), used more alcohol (p < 0.001) and had a higher incidence of syphilis than the LR group (p = 0.005). These differences remained the same when the abruptio's were analyzed as a separate group. Conclusions: Women who delivered preterm did experience more violence at some point in their lives and were also more likely to engage in high-risk behaviour. Violence alone does not seem to cause PTL directly, but is part of a low socioeconomic lifestyle. The fact that the alcohol use is so high among these women is a problem that needs to be addressed, but once again, it is possibly the result of deeper social problems. The need for education on values and respect, family planning use and low risk sexual behaviour is once again challenged.
AFRIKAANSE OPSOMMING: GEWELD TEEN VROUE -IMPAK OP REPRODUKTIEWE GESONDHEID EN UITKOMS VAN SWANGERSKAP Inleiding Daar word beraam dat tot 25% van alle swanger vroue aangerand word, maar die insidensie wissel tussen verskillende populasies. Ervarings van geweld kan 'n direkte of indirekte oorsaak wees van swak verloskundige uitkoms wat voortydse kraam, abruptio placentae en lae geboortegewig insluit. In die Wes- Kaap, onder die Kleurlingbevolking, is die insidensie van voortydse kraam 20%, wat swak vergelyk met die wêreldwye insidensie van 10%. Gedurende die laaste 40 jaar het die voorkoms van voortydse kraam nie verminder nie en geen deurbrake is gemaak t.o.v die oorsaak van die probleem nie. Die doel van hierdie studie was om te bepaal of vroue wat prematuur verlos moontlik meer geweld ervaar as vroue wat op normale swangerskapsduur verlos. Metodes Twee groepe vroue is bestudeer. Die eerste groep het vroue ingesluit wat spontaan verlos het tussen 24 en 33 weke (24wOd - 33w6d) of vroue wat na 24 weke swangerskapsduur toegelaat is vir onderdrukking van kraam. Vroue met plasentale loslating (abruptio placentae) voor 34 weke, sonder onderliggende hipertensiewe toestande, was ook ingesluit in die groep. Daar is m.b.v. 'n vraelys ("Abuse Assessment Screen") bepaal watter van die vroue gesinsgeweld ervaar het. Die tweede groep het vroue ingesluit met ongekompliseerde swangerskappe en wat by 'n nabygeleë kliniek voorgeboortesorg ontvang het. Hulle is ook gevra om die vraelys te voltooi en is opgevolg om die uitkoms van hulle swangerskappe te noteer. Die vraelyste is almal deur een persoon (J.S.) aan die vroue voorgelê nadat hulle ingeligte, skriftelike toestemming gegee het. Resultate 'n Totaal van 229 vroue was ingesluit, 99 in die lae risiko (LR) groep en 130 in die voortydse kraam (VK) groep, waarvan 23 abruptio placentae gehad het. In vergelyking met die LR groep, het die VK groep het betekenisvol meer geweld in hulle leeftyd ervaar (59.7% teenoor 40.4%, p = 0.038). Geweld wat tydens die afgelope jaar of tydens die swangerskap ervaar is, het nie betekenisvol verskil tussen die twee groepe nie, alhoewel die getalle hoër was vir die VK groep. Die VK groep het betekenisvol meer sigarette per dag gerook (p = 0.009), meer alkohol gebruik (p < 0.001) en het 'n hoër insidensie van sifilis gehad as die LR groep (p = 0.005). Hierdie verskille was steeds beduidend nadat dié met abruptio placentae as 'n aparte groep geanaliseer is. Gevolgtrekking Die vroue wat prematuur verlos het, het meer emosionele en fisiese geweld in hulle leeftyd ervaar en is meer geneig om 'n ongesonde leefstyl te handhaaf. Geweld blyk nie 'n direkte oorsaak van voortydse kraam te wees nie, maar gaan gepaard met 'n lae sosio-ekonomiese lewensstyl. Die hoë insidensie van alkoholgebruik onder swanger vroue is 'n probleem wat aangespreek moet word, maar dit is waarskynlik die manifestasie van dieper emosionele probleme. Opvoeding in terme van waardes en respek, gesinsbeplanning en veilige seksuele gedrag is gevolglik 'n noodsaaklikheid.
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Englund, Linnéa, and Evelina Persson. "Young women's sexual and reproductive health and rights in Ecuador." Thesis, Högskolan i Jönköping, Hälsohögskolan, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:hj:diva-34734.
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Mumtaz, Zubia. "Gender and reproductive health in Pakistan : a need for reconceptualisation." Thesis, London School of Hygiene and Tropical Medicine (University of London), 2003. http://researchonline.lshtm.ac.uk/4646513/.
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This thesis is a conceptual and empirical exploration of the links between women's gendered position and their reproductive health in Pakistan. A growing body of literature seeks to identify the relationship between gender inequality and women's reproductive health, most commonly their contraceptive use and fertility. However, to-date findings have been mixed and we lack a coherent picture of how these two aspects of women's well-being are related. This thesis illustrates that the focus on female autonomy, which is central to much of the discourse concerning gender and reproductive health in South Asia, is inappropriate to this cultural setting. An alternative framework for conceptualizing and measuring women's gendered position is presented in an attempt to further our understanding of the determinants of reproductive health. The study uses an integrated analysis of quantitative and qualitative data. The Pakistan Fertility and Family Planning Survey (1996-97) data show important socio-demographic and contextual differentials in women's mobility, decision-making, control over financial resources, communication with husband, exposure to information and health knowledge. Relationships between different measures of women's gendered position and reproductive health outcomes are shown to be varied, with only joint decision-making, communication with husband, and health knowledge having positive associations with both contraceptive and antenatal care use. A detailed ethnographic study of a Punjabi village reveals kinship structures based on an ideology of akhathe (jointness), and social networks and inter-personal relationships as the primary route to resources of all kinds. Women's interests are intricately linked with their family's well-being. They aspire to be mazboot (strongly connected) members of their families rather than autonomous individuals. The qualitative data inform the interpretation of the quantitative associations and suggest ways in which measures of women's gendered position can be refined. Both fertility control and pregnancy are shown to be highly gendered processes. However, an unexpectedly high contraceptive use rate, and the emergence of antenatal care use, are found in the absence of accompanying shifts in gender ideology. In such a context, the 'centrality' approach is suggested as a valid and sensitive way of conceptual ising women's gendered position in Pakistan. This approach incorporates the kinship and social structures and suggests women's mazbooti as a more acceptable and realisable goal for improving women's reproductive health and well being.
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Macleod, Catriona. "Public reproductive health and ‘unintended’ pregnancies: introducing the construct ‘supportability’." Oxford University Press, 2015. http://hdl.handle.net/10962/d1019881.
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In this Perspectives paper, I outline the limitations of the concept of ‘intentionality’ in public reproductive health understandings of pregnancy. ‘Intentionality’, ‘plannedness’, ‘wantedness’ and ‘timing’ place individual cognitions, psychology and/or behaviors at the center of public health conceptualizations of pregnancies, thereby leaving the underlying social and structural dynamics under-examined. I propose a model that places ‘supportability’ at the center of thinking about pregnancies and that allows for an analysis of the intersection of individual cognitions, emotions and behavior with micro-level interactive spaces and macro-level issues.Full text access on Publisher website: https://academic.oup.com/jpubhealth/article-lookup/doi/10.1093/pubmed/fdv123
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Graham, Elizabeth Miall Charlene. "An intensified pragmatism in repsonse [sic] to reproductive experiences and medicalization : a case study of Cape Breton women /." *McMaster only, 2003.
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Milanes, Lilian. "Health care providers' perspectives on male involvement in their sexual and reproductive health care needs." Honors in the Major Thesis, University of Central Florida, 2012. http://digital.library.ucf.edu/cdm/ref/collection/ETH/id/590.
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Young men are at the greatest risk of contracting sexually transmitted infections (STIs) within the U.S. male populations, yet are the least likely to make a sexual and reproductive health (SRH) care visit. Clinical approaches in these areas that include the outreach to and the involvement of male partners of female patients can prove particularly useful in expanding SRH care to men and can also improve health outcomes for women who have sex with men. In this study I examined UCF's healthcare provider's approaches to educate and involve men (between the ages of 18 and 30) and male partners of female patients in their SRH needs. I conducted qualitative semi-structured interviews with 18 health care providers at the Student Health Center; including physicians, physician assistants, and registered nurses. This study found that there were significant differences in perception of men's SRH risk behaviors among the providers. In addition, this study revealed issues that might deter male students from accessing care, specifically how patients are required to state to the operator (who is also an undergraduate student) their name, PID and exactly why they are scheduling a visit to the clinic, thus many men say they have cold symptoms instead of issues with SRH. This study is significant because it can contribute to improvements in the delivery of SRH care to male students on campus.B.A.
Bachelors
Sciences
Anthropology
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Hawkins, Kirstan. "Rights, health and power : a critical social analysis of the reproductive health and rights discourse." Thesis, Swansea University, 2002. https://cronfa.swan.ac.uk/Record/cronfa42673.
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This thesis is a critique of the global reproductive health and rights and discourse, which emanated from the 1994 International Conference on Population and Development. The thesis argues that far from being a new population policy paradigm, the reproductive rights and health discourse is a reworking of a neo-Malthusian and neo-liberal policy agenda. The thesis begins with a consideration of the historical and political context in which international population policy has evolved, and questions the extent to which liberal notions of individual rights freedom and choice, enshrined in the reproductive health discourse, bears a relationship to the social, political and economic realities in which poor and socially marginalized people experience their sexual and reproductive health. Through a critical review of the literature the thesis questions the positivist/functionalist paradigms upon which mainstream demographic and reproductive health research is based. In rejecting both the positivism of mainstream demography as well as the relativism of much post-modernism, the thesis draws eclectically upon post-structuralist and practice theory to suggest a framework for "critical social analysis", which understands sexual and reproductive behaviour as both historically grounded and culturally contingent. Central to the framework is an exploration of how constructions of identity and difference shape social and political practice at the national and local level. Drawing upon case study material from Bolivia, the thesis explores how constructions of identity and difference are embedded in historical and structural conditions of inequality and exploitation. Through an ethnographic study the thesis considers how these structural conditions of inequality become embodied in and reproduced through everyday practices, which ultimately shape the experience of health and well being among poor migrant women. The thesis goes on to suggest a methodological approach entitled the "peer ethnographic method" for incorporating such an understanding of identity and difference into programme design and monitoring.
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Liao, Rui Oratai Rauyajin. "Reproductive health rights a wareness of the rural-to-urban migrants in Yunnan, China /." Abstract, 2007. http://mulinet3.li.mahidol.ac.th/thesis/2550/cd400/4838031.pdf.
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Jimmy-Gama, Dixon. "An assessment of the capacity of faculty-based youth friendly reproductive health services to promote sexual and reproductive health among unmarried adolescents : evidence from rural Malawi." Thesis, Queen Margaret University, 2009. https://eresearch.qmu.ac.uk/handle/20.500.12289/7456.
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Despite the recognition of the influence of cultural norms on adolescent sexual behaviours in most societies (Kaler 2004; Chege 2005), less attention has been paid to the link between social norms and effectiveness of health facilities to promote adolescent sexual and reproductive health (ASRH). This thesis therefore examines the capacity of facilitybased youth-friendly reproductive health services (YFRHS) to promote ASRH in rural Malawian societies where culture strongly influences adolescent sexual behaviours. The study employs a social constructionist epistemology and a social interactionism theory to understand the capacity of YFRHS in ASRH promotion in rural Malawi. Qualitative and quantitative data were collected using a sequential exploratory design. Semi-structured in-depth interviews, participant observations, client exit interviews, survey, focus group discussions and review of health strategic and service utilisation documents/records were conducted. The results were generated by triangulating both qualitative and quantitative data. The findings of the study illuminate how social norms related to social identities influence adolescent sexual behaviours and ASRH promotion. An exploration of the cultural context reveals a major disjuncture between an ideal norm - no premarital sex - and a modelled norm where unmarried adolescents are expected to engage in unsafe sex. It also shows the conflicts between the cultural and scientific models of ASRH promotion. Structural gender asymmetry that emphasises subservience in females and hegemonic masculinity also reduces adolescents’ rights and agency in SRH promotion. The health providers are cultural agents. They manage diverse roles both as ‘moral guardians’ and as ‘health promoters’ in a way that limits their effectiveness as health promoters. The thesis concludes that the way facility-based YFRHS is implemented has limited impact on SRH promotion among unmarried adolescents of rural Malawi. The study recommends that appropriate health promotion interventions based on conscientisationoriented empowerment theories directed at adolescents, community and health workers should be used in ASRH promotion in societies with strong cultural influence on sexual behaviours.
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Olmo, Luisa. "Investigating smallholder cattle and buffalo reproductive health and management in Lao PDR to enhance reproductive efficiency and improve livelihoods." Thesis, The University of Sydney, 2020. https://hdl.handle.net/2123/21744.
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Low reproductive efficiency in smallholder cattle and buffalo in the Lao People’s Democratic Republic (Laos) is restricting the ability of rural households to supply the growing red meat demand in Asia, offering enhanced household income, livelihoods and regional food security. Factors contributing to low reproductive efficiency were investigated through screening cattle and buffalo serum against four abortifacient infections pathogens: Neospora caninum, bovine viral diarrhoea virus (BVDV), Leptospira interrogans serovar Hardjo and Brucella abortus. Analyses identified antibodies in 69-76%, 0-5%, 0-3% and 0% of buffalo, respectively, and in 4-8%, 8-10%, 13-22% and 0-0.3% of cattle, respectively. Based on associations to a complimentary risk factor survey, recommendations to reduce the risk of reproductive disease exposure in cattle and buffalo include preventing the common occurrence of village dogs consuming bovid placental membranes, disinfecting water troughs, and forage growing to avoid dry-season common-grazing. To address low calf survival associated with T. vitulorum parasitism, three field trials were analysed to assess the effects of fenbendazole molasses blocks (FMB). Calves receiving FMB recorded average daily gains 10-20g higher than control calves and faecal egg count reductions of 1-3% per day relative to control calves. Finally, knowledge, attitudes and practices (KAP) surveys were used to evaluate interventions and identified increasing the amount of land dedicated to growing improved forages and enhancing farmer market participation as associated to cattle and buffalo reproductive performance. The identification of interventions improving reproductive performance, a potential treatment for T. vitulorum, and risk factors for abortifacient pathogen exposure provides essential information needed for enhancing reproductive efficiency in cattle and buffalo in Laos.
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Dahlbäck, Elisabeth. "Between opportunities and risks : adolescent sexual and reproductive health in Zambia /." Stockholm, 2006. http://diss.kib.ki.se/2006/91-7140-978-5/.
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Nilses, Carin. "Health in Women of Reproductive Age : A Survey in Rural Zimbabwe." Doctoral thesis, Uppsala : Acta Universitatis Upsaliensis : Univ.-bibl. [distributör], 2000. http://publications.uu.se/theses/91-554-4893-3/.
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Kirkham, Jacqueline. "Sexual and reproductive health in Romania and Moldova : contexts, actors, challenges." Thesis, University of Glasgow, 2011. http://theses.gla.ac.uk/2586/.
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Over the past two decades sexuality and reproduction have proved potent and contested subjects. After the unexpected collapse of the state socialist systems, societies facing uncertainty and dislocation have turned both to the allure of ‘the west’ and to pre-socialist traditional values of family and gender. Along with this, aspirations of moving closer to Europe sits alongside a resurgent nationalist sentiment throughout the region, and it is sexuality and reproduction which has become a particularly contested battleground, as the female reproductive body has become a metaphor for the vitality and viability of the nation-state. Discourses of demographic crisis, calls to produce more (indigenous) children to increase the population and ensure the stability and viability of the state, and proscription of so-called ‘deviant’ (defined as non-heterosexual/non-reproductive) sexualities have all gained in currency as the nations of the region try to establish themselves as sustainable entities following the years of state-sponsored paternalism. At the same time, western nations and donor agencies offer support to redevelop and redesign out-of-date systems and bureaucracies and the opportunity to modernise and enjoy the benefits of capitalism and liberal democracy. A particular focus on developing civil society along with the reform of state institutions widens the social marketplace still further. It is against this backdrop that policy makers and service providers attempt to develop and provide health services. Public health is a useful barometer of what is happening in society, as it reflects the effects of wider socio-economic and political trends. Within this, the study of sexual and reproductive health is crucial as it also has the ability to illuminate the differential effects of societal change on different groups within society, such as women or those from minorities. It also powerfully illustrates the contestations going on in wider society around meanings of the moral and healthy, as sexuality and reproduction are issues pertinent to the continued reproduction of states and other ‘communities of power’. This thesis is a study of the experiences and perceptions of service providers in the field of sexual and reproductive health in Romania and the Republic of Moldova. Through interviews with service providers in both state and civil society sectors as well as regional and national authorities and international donor agencies, and an extensive media review of the portrayal of sexuality, reproduction and sexual and reproductive health, opportunities and barriers to providing accessible and responsive services within the contested arena of two postsocialist countries with much in common historically and culturally but following very different paths in the contemporary period are explored. The continuing importance of sexual and reproductive health as a category of study which can illuminate wider macro-level debates on national identity and vitality, as well as the importance of discursive battles over control of meanings, are amply illustrated in the thesis. In particular the relation between health and morality is extensively explored, and the relevance of an area studies approach to this wider topic is demonstrated. The thesis finds that it is vital to consider sexual and reproductive health services within their wider sociocultural context and that transnationally-funded initiatives do not take full account of the multiplicity of meanings and values underpinning the reactions of target populations to their services; indeed services are often framed as representing an unwelcome invasion of ‘alien’ morality. Ultimately providers and funders need to take the moral understandings of their target populations very seriously if they are to overcome the considerable opposition to their services.
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Chanchani, Devanshi. "Social inequality, reproductive health and child development : a Chhattisgarh village study." Thesis, University of East Anglia, 2015. https://ueaeprints.uea.ac.uk/53407/.
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India’s gains in reproductive health and child development have been slower than anticipated, and significantly the country continues to bear a disproportionate share of the global undernutrition burden. Indian children do particularly poorly in the foundational foetal stage and in the first three years, and public programmes are especially ineffective in reaching this group. While it is recognised that reproductive health and child nutrition is determined complexly, having biomedical and social roots, positions from a policy perspective are oftentimes competing – on whether key barriers are primarily economic or essentially cultural. Additionally, an argument explaining the South Asian nutrition ‘enigma’ emphasises the mediating role of female power, often measured as female decision-making autonomy. I discuss based on research in a village in the rice-growing plains of Chhattisgarh the complex and interrelated cultural, economic and gender-based variables as they bear on reproductive health and nutrition for the different social groups in the village. I argue that this under-researched geography at the confluence of Indo-Aryan and Dravidian cultural streams has interesting insights to offer for social theory into the determinants of female power. Important elements of northern kinship based on exogamous principles, theoretically less favourable for female autonomy than ‘southern’ kinship systems, counter-intuitively go alongside relatively egalitarian gender relations, also evidenced by sex-ratios, and other telling indicators. Furthermore, not fitting with mainstream discourse on female autonomy’s positive demographic and health implications, relatively egalitarian gender relations and sex-ratios go alongside poor performance on other demographic, health and nutrition outcomes. For caste groups in the village, elements of northern kinship appear to bear on son-preference, and undermine a woman’s independence in fertility related decision-making. However, beyond an influence on fertility the influence of gender-inequality on reproductive and child development outcomes could not be read off from observations or expressions of decision making power. I argue that it may be useful to broaden the gender-lens beyond a narrow conceptual focus on decision-making autonomy to include structural dimensions such as rigidities in gender division of labour. Behaviours and practices relevant to reproduction and childrearing vary significantly from biomedical recommendations. These reveal both economic and cultural roots. Judged against biomedical norms, health and childcare behaviours shaped by ideational beliefs are at greater variance for the post-partum stage than during pregnancy. Cultural food proscriptions have little relevance during pregnancy, implying that concerns of ‘eating down’ in pregnancy for its influence on foetal growth are of little consequence for this geography. I argue that there are important economic barriers that place limits on diet quality in pregnancy, yet there is some scope for health-facilitating resource reprioritisation. Health and childcare behaviours in the post-partum stage diverge to a greater extent from recommended biomedical practice, and could be damaging to nutritional status of the mother and child. While these practices have a clear ‘ideational’ element, they are also rooted in fear of both ill health and economic distress, deriving perhaps from the historical experience of communities in a poor health environment. I discuss from the curious case of the nutritionally vulnerable Pardhi tribe, and their rejection of the public works NREGA programme that there are iterative cultural and nutritional factors that influence poverty for this community, notwithstanding oppressive social and political relations. Productive activity perceived to involve high energy expenditure, while seemingly economically attractive can be rejected in contexts where communities aim to preserve ‘body-capital’. Further conventional classifications of what is considered routine unskilled work under NREGA may be rejected because of cultural unfamiliarity and unfamiliar body techniques. The wider marginalisation of the community and oppressive social relations may further contribute to Pardhi rejection of public programmes. In addition, entrenched local political rivalries work against public interest to mediate the everyday welfare state and implementation of reproductive health and nutrition programmes such as the Integrated Child Development Services (ICDS).
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Nara, Ruth. "Understanding the Reproductive Health Needs of Displaced Congolese Women in Uganda." Thesis, Université d'Ottawa / University of Ottawa, 2018. http://hdl.handle.net/10393/38394.
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Uganda currently hosts 1.4 million refugees and conflict-affected people. Known as the “best place” in Africa to be a refugee, Uganda’s policies encourage self-sufficiency and local integration. However, many refugees, particularly women and girls, face persistent challenges. Understanding the reproductive health needs of this population and exploring the accessibility of services for conflict-affected populations in this low-income host country is a priority. This multi-methods study aimed to assess the reproductive health needs of displaced Congolese women in camp- and urban-based settings in Uganda. We interviewed key informants, facilitated focus group discussions with refugee women, and conducted in-depth interviews with Congolese women of reproductive age to better understand knowledge, attitudes, practices, and services. Our results suggest that Congolese refugees have significant unmet reproductive health needs. Maternal health and delivery care is characterized by insufficient human resources, inconsistent medication availability, discrimination, bribery, and communications challenges. The availability of contraceptive products, including emergency contraception, is limited in camp-based settings due to supply-chain management challenges and theft by staff; lack of contraceptive knowledge among Congolese refugees shapes use. Finally, the legal restrictions on abortion lead to unsafe practices among refugees and pose a barrier to the provision of post-abortion care. This study provides insight for opportunities to improve the delivery of sexual and reproductive health services to refugees in Uganda to ensure that the infrastructure and processes align with national policies and international guidelines.
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Mpilambo, Jacques Elengemoke. "Reproductive health situation among youth in the Democratic Republic of Congo." Thesis, University of the Western Cape, 2015. http://hdl.handle.net/11394/5195.
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Magister Philosophiae - MPhilBackground: In the Democratic Republic of Congo, 22.2% of the total population is in the age group of 15 to 24 years. In this country, this population group faces a large number of reproductive health problems. Even though the concerned health officials have implemented several health care programs, the youth particularly girls still have many problems particularly lack of sexual health information, poor health care, inability to avoid early and unprotected sexual relationships, early marriage, early pregnancies, early childbearing, etc. Objectives: The aim of this study is to examine reproductive health issues among young women and to understand how they utilise the health care systems in their respective socio-economic and demographic characteristic. Data and Methods: Descriptive and multivariate analyses were used. Cross tabulation, Chi-square, Phi coefficient and Cramer‘s V were applied to test for association between independents and outcome variables. At multivariate level of analysis, binary logistic regression was performed. All analyses were performed using the Statistical Package for Social Sciences (SPSS) version 23.0. Results: The study found that young women who faced early sexual intercourse (OR=73.5) and those who experienced it at 16-17 (OR= 42.3) are more at risk of early marriage than those who initiated at the age 18-24. Meanwhile, young women with no education (OR=14.1), primary and secondary education (OR=10.7 and OR=8.6 respectively) have a higher risk of early union than their higher educated counterparts. Furthermore, respondents who married in their early adolescence (OR=38.3) and middle (OR=20.0) adolescence are more at risk of early childbearing than those who married in their emerging adulthood. Moreover, young women from Maniema, Equateur and Bas Congo provinces are 95%, 62% and 58% (respectively) less likely to have had at least four ANC visits than those from Kinshasa. Conclusion: There is an urgent need for formal sex education before first sexual initiation to give better options than early marriage to adolescent girls. Also, the disparities in the antenatal care services utilization between provinces should be addressed. The concerned authorities should balance the distribution of health facilities and qualified personal among provinces.
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Hoque, A. M. Mozibul Santhat Sermsri. "Sexual behaviour, contraceptive practice and reproductive health among Thai school adolescents /." Abstract, 1999. http://mulinet3.li.mahidol.ac.th/thesis/2542/42E-MozibulH.pdf.
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Zerucelli, Rucell Jessica. "Obstetric violence & colonial conditioning in South Africa's reproductive health system." Thesis, University of Leeds, 2017. http://etheses.whiterose.ac.uk/20747/.
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This dissertation outlines the relationship between obstetric violence, and colonial era conditioning. Examining South Africa’s post-1994 public health system, I argue societal norms, political-economic arrangements, health systems, and their policies, have established structural violence which generates and spreads a continuum of violent practices within reproductive health services. The rationalisation and obfuscation of violence against Black women throughout the colonial and apartheid periods, including coercive contraception protocols, indexes more than simply gender-based violence in health services. I propose a theoretical underpinning: obstetric structural violence to explain what I argue is a particular type of violence against women. I interrogate the systematic violation of sexual and reproductive health rights enacted by health systems, resulting in: 1) non-consensual constraint of reproductive autonomy, 2) preventable maternal and neonatal disability, 3) mortality. Part 1 analyses the colonial conditioning that led to health services becoming constitutive of racial, and gendered structural violence. Historical stereotypes of sexuality are linked to rationalisations of contemporary obstetric violence. Examining the political-economy of the democratic period, Part 2, demonstrates how constant reform and limited power undermine low-level managers capacity to ensure the functioning of accountability, thereby propagating obstetric violence. Drawing on extensive qualitative fieldwork within seven primary–tertiary hospitals, I describe how routine, as well as episodic, physical and psychological forms of direct obstetric violence are pervasive. I argue these outcomes prove the connection between obstetric violence, adverse health, and obstetric malpractice, a fact often absent from related literature. Lastly, I argue the resultant case law and individual awards from obstetric malpractice for incurred patient harms, encourages the invisibility of obstetric, and obstetric structural violence.
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Nguyen, Quynh Anh. "Economic evaluation of adolescent reproductive health education interventions in Chilinh, Vietnam." Thesis, Queensland University of Technology, 2014. https://eprints.qut.edu.au/79547/1/Quynh%20Anh_Nguyen_Thesis.pdf.
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This research was an economic analysis of two novel health education interventions compared to existing practice for reproductive health among young people in northern Vietnam. The research showed that implementing an educational intervention including school-based and health facility-based components was cost effective for males and females. The findings will assist decision makers in efficient allocation of scarce resources for adolescent health promotion in Vietnam and similar socio-economic contexts in Asia.
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Magnusson, Brianna. "Contextual Factors and Reproductive Control in U.S. Women." VCU Scholars Compass, 2011. http://scholarscompass.vcu.edu/etd/190.
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Introduction: Access to family planning services is a major public health issue. State policies and funding for family planning services may increase access to contraceptive services and help women avoid unintended pregnancies. Study Design: We identified sexually active, fertile women participants of the National Survey of Family Growth (2006-2008). Women were categorized as consistent or inconsistent users of contraceptives based on self-report. States were classified based on 2006 Medicaid family planning waiver status (income expansions, limited expansions, or no Medicaid family planning expansions), 2006 public funding for family planning in dollars per woman, and insurance coverage of contraceptive mandate status (comprehensive mandate, partial mandate, or no mandate). Multi-level logistic regression was used to estimate the extent to which state-level constructs increase consistent contraceptive use among reproductive aged women at risk of unintended pregnancy. Results: Women living in states with an Medicaid family planning income expansion waiver had 44% increased likelihood of consistent contraceptive use relative to women living in states with no Medicaid expansions (adjusted odds ratio (aOR): 1.44; 95% confidence interval (CI): 1.06-1.96). Limited Medicaid expansion was also associated with consistent contraceptive use (aOR: 1.30; 95% CI: 0.91-1.87). Nationwide a median of $86 (Interquartile range: $59-$133) of total public family planning funding was spent per woman in 2006. Higher levels of total public funding per woman for family planning services were not associated with an increase in the odds of consistent contraceptive use among all women (OR:1.05; 95% CI:0.98-1.12) or among women with incomes <250% of the federal poverty level (OR:1.06; 95%CI: 0.96-1.17). Comprehensive insurance coverage of contraceptives mandates increased the likelihood of consistent contraceptive use for privately insured women (aOR: 1.64; 95% CI: 1.08-2.50). Partial mandates were not associated with consistent contraceptive use. No association was observed among uninsured women (aOR: 0.77; 95%CI: 0.38-1.55). Conclusions: Comprehensive insurance mandates and income-based Medicaid eligibility expansions are associated with increased likelihood of consistent contraceptive use. More research is needed to understand the association between public funding for family planning and contraceptive use among women in need of publicly funded services.