农村已婚育龄妇女生殖健康检查情况分析

目的：通过对我区农村已婚育龄妇女进行生殖健康检查以及随访服务,了解我区已婚育龄妇女的生殖健康状况,增强自我保健意识,提高妇女健康水平,为计划生育优质服务进一步深化提供依据。方法：对我区已参加生殖健康检查的已婚育龄妇女人群中随机抽取30000人,对检查结果进行分析。结果：本次检查30000例,患病15150人,总患病率50.5%。讨论：我区农村已婚育龄妇女患妇科疾病仍较普遍,大部分以缺乏对生殖道感染的认识和医疗资源不足,经济困难等为主要影响因素,因此对已婚育龄妇女生殖健康应采取有效的干预措施,切实保障已婚育龄妇女生殖健康水平,降低妇科病患病率,提高生活质量。     

开展避孕节育优质服务对农村育龄妇女人工流产状况的影响

目的:了解开展避孕节育优质服务后,甘肃省农村已婚育龄妇女人工流产状况的变化。方法:从甘肃省永靖县、临泽县随机选择6个乡镇育龄妇女分为干预组和对照组进行基线调查,于2002年1月起对干预组育龄妇女进行“避孕节育知情选择和计划生育优质服务”系列宣传、教育、培训。终期调查于2004年3月干预措施结束时进行。结果:甘肃省农村已婚育龄妇女在基线和终期调查中,干预组人工流产率分别为4.27%和2.91%,对照组分别为4.04%和3.49%。终期调查干预组不同社会特征育龄妇女人工流产率与对照组比较均无统计学意义,且均低于基线调查时结果。干预组中接受避孕知识宣传材料或培训活动超过3次的育龄妇女,其人工流产率低于对照组。Logistic多元回归结果显示,对紧急避孕知识缺乏了解,文化程度高且理想子女数多者易发生人工流产。结论:开展及加强“避孕节育知情选择”,有利于降低农村已婚育龄妇女的人工流产率,提高生殖健康的水平,维护其身心健康;应进一步加大计划生育优质服务的力度,正确引导农村育龄妇女的避孕行为,降低人工流产率。     

开展避孕节育优质服务对农村育龄妇女人工流状况的影响

目的了解开展避孕节育优质服务后,甘肃省农村已婚育龄妇女人工流产状况的变化.方法从甘肃省永靖县、临泽县随机选择6个乡镇育龄妇女分为干预组和对照组进行基线调查,于2002年1月起对干预组育龄妇女进行"避孕节育知情选择和计划生育优质服务"系列宣传、教育、培训.终期调查于2004年3月干预措施结束时进行.结果甘肃省农村已婚育龄妇女在基线和终期调查中,干预组人工流产率分别为4.27%和2.91%,对照组分别为4.04%和3.49%.终期调查干预组不同社会特征育龄妇女人工流产率与对照组比较均无统计学意义,且均低于基线调查时结果.干预组中接受避孕知识宣传材料或培训活动超过3次的育龄妇女,其人工流产率低于对照组.Logistic多元回归结果显示,对紧急避孕知识缺乏了解,文化程度高且理想子女数多者易发生人工流产.结论开展及加强"避孕节育知情选择",有利于降低农村已婚育龄妇女的人工流产率,提高生殖健康的水平,维护其身心健康;应进一步加大计划生育优质服务的力度,正确引导农村育龄妇女的避孕行为,降低人工流产率.     

“计划生育/生殖健康优质服务”国际研讨会

由国家人口和计划生育委员会主办,WHO、UNFPA及FORD基金会联合资助,上海市计划生育科学研究所承办的“计划生育/生殖健康优质服务”国际研讨会,于2005年11月15-17日在上海举行。会议旨在讨论及总结中国及其他发展中国家的计划生育和生殖健康优质服务项目的成果及影响,与各国交流并分享该领域的经验,达到促进计划生育/生殖健康优质服务的目的。会议主要议题包括:计划生育优质服务的概念和理论;避孕方法的有效性评估;新的生殖健康和避孕方法的(再)引入;青少年生殖健康;RTI/STD/AIDS的预防,婴儿/儿童健康和计划生育,计划生育与家庭健…     

男性参与计划生育状况及其影响因素分析

目的:分析男性参与计划生育状况及其影响因素。方法:对全国31个省16 994名已婚育龄妇女进行问卷调查。结果:近10年来,有48.05%的男性与妻子讨论过避孕,25.75%的男性参加过计划生育/生殖健康培训,14.90%的男性参与避孕方法决策,27.59%的男性曾经使用过避孕套,5.10%的男性采用男性绝育术。多因素分析结果提示:男性参与与居住地(城镇/农村)、本人或妻子的文化程度等有较大关联。结论:我国男性尤其是农村男性参与计划生育程度有待提高。建议加大男性参与宣传教育的力度,扩展男用避孕方法种类以及全面推进避孕方法知情选择。     

开展已婚育龄妇女生殖健康普查监护对降低生殖道感染、宫颈癌发病的影响

目的:了解开展已婚育龄妇女生殖健康普查监护对降低生殖道感染、宫颈癌发病的影响。方法:用不同检查方法对7027位妇女进行检查监护,对不同监护次数的育龄妇女生殖健康状况在妇科检查、实验室检查等方面的体检资料进行对比分析。结果:生殖健康监护率越高生殖道感染、宫颈癌发病率越低。结论:加强已婚育龄妇女生殖健康检查监护,及时了解育龄妇女生殖健康状况,做到早发现、早治疗,切实提高广大育龄妇女的生殖健康水平。     

上海闵行区人工流产女性避孕知识的调查与分析

目的:了解人工流产女性的避孕状况,为进一步实施干预、提高育龄妇女生殖健康水平提供依据。方法:面对面问卷访谈,收集和了解要求人工流产女性术前避孕知识、避孕情况等信息进行分析,提出应对措施。结果:726例人工流产访谈女性多数为已婚(75.48%);一次以上的重复流产达57.99%,未婚人工流产占24.52%。未采取避孕措施(51.38%)或避孕失败(48.62%)是导致意外妊娠的主要原因。访谈对象对避孕套、口服避孕药、宫内节育器有所知晓,但对其他避孕方法知之甚少。访谈对象中知道免费提供避孕药具专门机构者仅35.54%。结论:降低重复流产和未婚人工流产是当务之急。对此,需要广泛、持久、深入开展计划生育健康教育,提高育龄人群避孕意识、避孕知识水平。同时,需要加强人工流产后生殖保健服务。     

拉萨地区已婚育龄妇女避孕方法应用现况

目的 :了解拉萨地区已婚育龄妇女正在使用中的避孕方法概况。方法 :对拉萨市、区、局各单位已婚育龄妇女进行计划生育、生殖健康普查 ,将调查结果填表 ,并进行统计分析。结果 :该地区所应用的避孕法共 6类 ,其中绝育术、宫内节育器、药物 (口服、针剂、皮埋剂 )及阴道药具避孕法为主要避孕措施。不同年龄组妇女应用避孕方法的种类不同 ,35岁以上妇女绝育术的应用率呈升高趋势 ;30～ 35岁年龄组妇女的宫内节育器应用率高 ;而小于 35岁的妇女多选用药物和阴道药具避孕法。结论 :反映了该地区和国内其他地区一样 ,避孕方法的选用呈多种类、高质量的发展趋势     

社区妇女避孕知识与行为状况调查与分析

目的:了解社区妇女对避孕知识的知晓和行为状况,以便更好地为她们提供计划生育服务和教育,提高避孕节育知情选择的正确率。方法:采用自行设计的调查表,以问卷调查的形式,对385例社区妇女进行问卷调查。结果:各种避孕知识及避孕方法知晓率为86%,行为正确率64%,其中紧急避孕行为正确率偏低。影响避孕知识水平的因素是文化程度的高低和职业。结论:要加大计划生育的宣传、咨询和指导力度,为社区妇女提供多种形式的、有针对性的机会生育优质服务,提高育龄妇女对避孕节育方法,尤其是紧急避孕方法的知晓度,扩大她们对避孕节育方法的选择范围,减少非意愿妊娠的发生。     

知情选择在避孕节育措施的影响

目的:探讨避孕方法知情选择在已婚育龄妇女避孕节育知识、自愿知情选择避孕方法的影响。方法:对839位育龄妇女采用问卷调查的方法了解其避孕的相关知识,对健康教育后的799人节育措施实施情况进行追踪,并进行相关的统计分析。结果:目标人群有关避孕节育知识的知晓率有不同程度提高;育龄群众能在一定程度上主动选择避孕方法,其避孕方式正朝着多样化方向发展。结论:避孕方法知情选择的健康教育活动,不仅使育龄群众掌握了多种避孕节育知识,同时获取了生殖健康的基本知识,真正实现知情选择,科学避孕。     

四川省城镇人工终止妊娠人群的生殖健康服务需求及相关因素

目的:了解四川省城镇人工终止妊娠人群对生殖健康服务的需求。方法:对四川省城镇4 2 83例人工终止妊娠妇女进行问卷调查。结果:调查对象中91 %需要不同形式的计划生育服务,78%需要妇幼保健、产前保健、优生、性传播疾病防治等服务。所需获得这些服务的途径包括咨询、视听媒体、宣传资料、听课或家庭医生服务。73%的调查对象希望得到市、省级以上单位提供的服务。结论:我省人工终止妊娠妇女生殖健康服务的需求量大,形式多样。有必要通过易接受的书面、声象媒介,咨询等方式提高该人群的生殖健康知识水平。同时,加强对计划生育和卫生工作人员的培训,提高服务质量,扩大服务范围,避免意外妊娠及不必要的人工终止妊娠。     

Using situation analysis to assess women''s perceptions of quality of maternal-child health and family planning services

Situation analysis is one method of measuring the quality of health services and was developed to assess the readiness of family planning service delivery sites to provide quality contraceptive services. Although situation analysis has also been used to describe the quality of contraceptive services delivered, the information ithas been able to provide to date is more limited. Using mainly the example of three studies ofmatemal-child health and Family planning services in Botswana, Tanzania, and Kenya, this paper describes how the methodologyis used and its strengths and limitations for assessing quality of non-contraceptive reproductive health services. These include the costs women have to pay, privacy, provision of information to women and other inter-personal interactions, provider performance and training, and women's satisfaction with services. VVhile situation analysis could benefit from several improvements, its primary role should continue to be highlighting broad areas of deficiency in quality of service provision, to which other, more specific instruments can be applied to gain in-depth information.     

避孕方法知情选择干预措施对已婚育龄妇女避孕知识水平的影响

目的:评价避孕方法知情选择干预措施对已婚育龄妇女避孕知识、知情选择相关知识和态度的影响,探索影响干预效果的潜在因素。对象和方法:本研究以计划生育门诊为基础的干预研究,进行基线调查后对到干预门诊就诊的妇女进行避孕节育知情选择宣教,培训干预门诊的服务人员并提供咨询服务,干预后进行效果评估调查。结果:干预措施显著提高了干预组服务对象避孕知识、知情选择知晓率和正确理解程度,提高了服务提供者的咨询技巧。计划生育干部和技术人员认为基层技术人员数量少、素质低,给知情选择的开展带来一定的困难。结论:应通过多种渠道给予育龄群众更广泛全面的信息,加强基层服务提供者的培训。     

Equity of access to and utilization of reproductive health services in Thailand: national Reproductive Health Survey data, 2006 and 2009

This study assessed trends in equity of access to reproductive health services and service utilization in terms of coverage of family planning, antenatal care and skilled birth attendance in Thailand. Two health indicators were measured: the prevalence of low birthweight and exclusive breastfeeding. Equity was measured against the combined urban–rural areas and geographic regions, women's education level and quintiles of household assets index. The study used data from two nationally representative household surveys, the 2006 and 2009 Reproductive Health Surveys. Very high coverage of family planning (79.6%), universal antenatal care (98.9%) and skilled birth attendance (99.7%), with very small socioeconomic and geographic disparities, were observed. The public sector played a dominant role in maternity care (90.9% of all deliveries in 2009). The private sector also had a role among the higher educated, wealthier women living in urban areas. Public sector facilities, followed by drug stores, were a major supplier of contraception, which had a high use rate. High coverage and low inequity were the result of extensive investment in the health system by successive governments, in particular primary health care at district and sub-district levels, reaching universality by 2002. While maintaining these achievements, methodological improvements in measuring low birthweight and exclusive breastfeeding for future reproductive health surveys are recommended.     

Neoliberal reforms and privatisation of reproductive health services in post-socialist Poland

The fall of state socialism in Poland in 1989 constituted a critical moment which redefined policies on reproductive health care and access to family planning, influenced by the renewed power of the Catholic church. Poland also embarked on neoliberal economic reforms that resulted in major cutbacks in social services and state health care coverage. The confluence of the elimination of contraceptive subsidies, privatisation of health care, and the intensification of bribes to underpaid health care providers created new challenges for women in accessing services. Furthermore, the 1993 ban on abortion resulted in a nearly total privatisation of this service, which is currently available clandestinely at a high price. Drawing on anthropological research in the Gdańsk metropolitan region in 2007, this paper examines the restrictions on access to family planning, abortion, maternity care, assisted reproduction and other gynaecological services. It draws attention to the urgent need for state-subsidised family planning and other reproductive health services, the reform of abortion law, and regulation of privatised services. Higher wages for public sector health professionals and better public health provision would curb informal payments. The state should support the legitimacy of women's health needs and reproductive and sexual autonomy.     

Safe abortion: a right for refugees?

Thanks to initiatives since 1994, most reproductive health programmes for refugee women now include family planning and safe delivery care. Emergency contraception and post-abortion care for complications of unsafe abortion are recommended, but provision of these services has lagged behind, while services for women who wish to terminate an unwanted pregnancy are almost non-existent. Given conditions in refugee settings, including high levels of sexual violence, unwanted pregnancies are of particular concern. Yet the extent of need for abortion services among refugee women remains undocumented. UNFPA estimates that 25-50% of maternal deaths in refugee settings are due to complications of unsafe abortion. Barriers to providing abortion services may include internal and external political pressure, legal restrictions, or the religious affiliation of service providers. Women too may be pressured to continue pregnancies and are often unable to express their needs or assert their rights. Abortion advocacy efforts should highlight the specific needs of refugee women and encourage provision of services where abortion is legally indicated, especially in cases of rape or incest, and risk to a woman's physical and mental health. Implementation of existing guidelines on reducing the occurrence and consequences of sexual violence in refugee settings is also important. Including refugee women in international campaigns for expanded access to safe abortion is critical in addressing the specific needs of this population.     

Reproductive health services in South Africa: From rhetoric to implementation

Since its transition to democracy in 1994, South Africa had made some bold moves towards developing a health sector that better meets the needs of its population. The government is committed to reproductive health and women's development, but the challenge of translating these commitments into services on the ground still lies ahead. Based on data from a review of maternal health services and a research and implementation project in three South African provinces, this paper examines the current capacity of the health sector in South Africa to respond to women's reproductive health needs. The studies show that women want better quality from existing services and the opening of services where none exist. Obstacles to providing quality care throughout the provinces were identified, eg. perceived and actual problems with provider-client relations, staff workload, waiting times to be seen, in adequacy of infrastructure, lack ofphones and transport for referrals, and poor management of resources and staff, indicating poor health systems management overall. This paper argues that investing in improving the health care system as a whole is essential to achieving high quality reproductive health services.     

Mobility of women and access to health and family planning services in Pakistan

Women's access to health and family planning services is limited in Pakistan, despite a growing contraceptive prevalence rate. In 1997, a small, qualitative study in three villages in rural Punjab explored restrictions on female mobility and other social barriers to accessing these services, in relation to women's status, concepts of honour and the practice of segregation of the sexes. Focus groups with married men and women, and unmarried girls, and key informant interviews were conducted in each site. Unmarried girls were most restricted in all types of mobility, even within their own villages. Attitudes towards health and family planning services were positive among both men and women, and women's access to these services within their own villages was least restricted. However, the unmarried girls experienced restrictions on accessing health care even within their own villages. Accessing services outside the village was more restricted for all women, as they rarely left their villages alone. Mobility for education or jobs outside the village was more severely controlled because it poses more of a threat to the honour code. These findings have implications for health and family planning programmes in Pakistan. Services must begin to improve outreach to unmarried girls and door-to-door service provision will need to avoid the pitfall of accommodating existing social barriers, instead of helping women to overcome them.     

Reproductive health: knowledge and opinions of university students in Erzurum, Turkey.

BACKGROUND: The aim of this study was to assess knowledge of reproductive health and the opinions of university students towards reproductive health education and family planning services. METHODS: A questionnaire about reproductive health knowledge and the opinions of students was submitted to 673 systematically and randomly selected students at Ataturk University. A set of 39 questions was used to determine the level of knowledge of reproductive health. RESULTS: The level of reproductive health knowledge was below the theoretical mean value. An association was found between gender, residential area, parents' education and sibling number with the reproductive health knowledge score. Most of the students approved of formal reproductive health education (88.4%). Approval of family planning services was lower than that of reproductive health education (71.6%). The percentage of men who support family planning services and reproductive health education was lower than that of women. Students who had graduated from Islamic religious schools had more negative opinions towards family planning services. CONCLUSIONS: University students lack knowledge about reproductive health and most of them agree that reproductive health education should be given in schools. Knowledge about reproductive health differs significantly depending on some sociodemographic variables. Some students have negative opinions towards family planning services and reproductive health education.     

Brazil assessment finds unmet needs in the public sector

An assessment conducted in municipalities in four of Brazil's nine states in 1993 revealed high rates of unwanted fertility. As many as 58% of pregnant women reported that their current pregnancy was either unwanted or mistimed. Despite Ministry of Health approval for the provision of oral contraceptives, IUDs, condoms, spermicides, diaphragms, and natural family planning methods, public-sector programs generally offered a limited range of contraceptive options and frequently were out of supplies. Also observed by the assessment team was a strong medical (as opposed to primary health care) orientation among contraceptive providers and a lack of training of physicians and nurses in family planning. On the basis of this assessment, the team recommended that efforts be directed toward strengthening the provision of methods that are often unavailable (e.g., IUDs, barrier methods, and lactational amenorrhea) rather than expanding contraceptive options. Research currently underway in Sao Paulo state seeks to identify the operational and management changes necessary to broaden contraceptive choice and improve the quality of reproductive health services. A data collection and information retrieval system has been set up to record health post activities, and a family planning training and referral system has been established. The Brazil assessment was conducted according to a three-stage model devised by the UNDP/UNFPA/WHO/World Bank Special Program of Research, Development, and Research Training in Human Reproduction.