Reproductive Health

Introduction of reproductive health:

• The term 'Reproductive health' simply refers to healthy reproductive organs with normal functions. However, it has a broader perspective and includes the emotional and social aspects of reproduction also.
• According to the World Health Organisation (WHO), reproductive health means total well-being in all aspects of reproduction, i.e., physical, emotional, behavioural, and social.
• Therefore, a society with people having physically and functionally normal reproductive organs and normal emotional and behavioural interactions among them in all sex-related aspects might be called reproductively healthy.

Goals of RCH Programmes: 

• To create awareness among people about various aspects related to reproduction.  

• To provide the facilities to people to understand and build up reproductive health.  

• To provide support for building up a reproductively healthy society.  

• To bring about a change mainly in three critical health indicators i.e. reducing total infertility rate, infant mortality rate and maternal mortality rate. 

The goals of RCH can be achieved by the following ways: 

• By introduction of sex education in schools. Proper information about safe and hygenic sexual practices, sexually transmitted diseases (STD, AIDS), problems related to adolescence and proper information about reproductive organs. 

• By educating the younger generation about birth control measures, pre-natal care of pregnant woman and post-natal care of the mother and child, importance of breast feeding. 

• By creating awareness about statutory ban on amniocentesis for sex determination.By creating awareness about child immunization programmes.     

Reproductive health means a total well being in all aspects of reproductive i.e. physical emotional, social and behavioural.

Sexually transmitted disease (STDs):-

-Many disease can be sexually transmitted such as:

(i) Bacterial: Gonorrhoea and syphilis

(ii) Viral: Warts and HIV- AIDS

-Use of condom prevents these infections to some extent.

-Contraception: It is the avoidance of pregnancy, can be achieved by preventing the fertilisation of ova.

Methods of contraception

(i) Physical barrier:

-To prevent union of egg and sperm

-Use of condoms, cervical caps and diaphragm.

(ii) Chemical methods:

-Use of oral pills

-These change hormonal balance of body so that eggs are not released

-May have side effects

(iii)Intrauterine contraceptive device. (IUCD)

-Copper – T or loop is placed in the uterus to prevent pregnancy

(iv)Surgical Methods:

-In males the vas deferens is blocked to prevent sperm transfer called vasectomy.

-In females the fallopian tube is blocked to prevent egg transfer called tubectomy.

Female Foeticide:

-The practice of killing a female child inside the womb is called female foeticide

-For a healthy society, a balanced sex ratio is needed that can be achieved by educating people to avoid malpractices like female foeticide and prenatal sex determination.

-Pernatal sex determination is a legal offence in our country so as to maintain a balanced sex ratio.

1. India was amongst the first countries in the world to initiate action plans and programmes at a national level to attain total reproductive health as a social goal. Family planning measures were initiated in 1951 in India. The goal was to attain total reproductive health. These measures were periodically evaluated.  
2. Reproductive and Child Health Care (RCH) Programs are being operated with the aim of creating awareness among people about various reproduction related aspects and providing facilities and support for building a reproductively healthy society. 

Strategies to build a reproductively healthy society:

1. Governmental and non-governmental agencies should use media-both print and audio-visual, to create awareness programs. 
2. Responsible adults, parents, teachers, close relatives, and friends should provide correct information and be willing to open dialogues with young adults and children to sensitize them about reproductive health.
3. Introduction of sex education in schools should also be encouraged to provide the right information to the young so as to discourage children from believing in myths and having misconceptions about sex-related aspects.
4. Proper information about reproductive organs, adolescence and related changes, safe and hygienic sexual practices, sexually transmitted diseases (STD), AIDS, etc., would help people, especially those in the adolescent age group to lead a reproductively healthy life.
5. Educating people, especially fertile couples and those in the marriageable age group, about available birth control options, care of pregnant mothers, post-natal care of the mother and child, the importance of breastfeeding, equal opportunities for the male and the female child, etc., would address the importance of bringing up socially conscious healthy families of the desired size.
6. Awareness of problems due to uncontrolled population growth, social evils like sex abuse and sex-related crimes, etc., need to be created to enable people to think and take up necessary steps to prevent them and thereby build up a socially responsible and healthy society.
7. Successful implementation of various action plans to attain reproductive health requires strong infrastructural facilities, professional expertise and material support. These are essential to provide medical assistance and care to people in reproduction-related problems like pregnancy, delivery, STDs, abortions, contraception, menstrual problems, infertility, etc.
8. Implementation of better techniques and new strategies from time to time are also required to provide more efficient care and assistance to people.
9. Statutory ban on amniocentesis for sex-determination to legally check the increasing menace of female foeticides, massive child immunization, etc., are some programmes that merit mention in this connection. In amniocentesis, some of the amniotic fluid of the developing foetus is taken to analyze the fetal cells and dissolved substances. This procedure is used to test for the presence of certain genetic disorders such as, down syndrome, haemoplilia, sickle-cell anemia, etc., to determine the survivability of the foetus.
10. Research on various reproduction-related areas is encouraged and supported by governmental and non-governmental agencies to find out new methods and/or to improve upon the existing ones. ‘Saheli’– a new oral contraceptive for females - was developed by scientists at Central Drug Research Institute (CDRI) in Lucknow, India.
    

    ‘Saheli’– a new oral contraceptive pills

Better awareness about sex-related matters, increased number of medically assisted deliveries, and better post-natal care leading to decreased maternal and infant mortality rates, increased number of couples with small families, better detection and cure of STDs, and overall increased medical facilities for all sex-related problems, etc. all indicate improved reproductive health of the society.

Amniocentesis is a foetal sex and disorder determination test based on the chromosomal pattern of the embryo’s cells in the amniotic fluid surrounding the developing embryo.  

Procedure:  Amniotic fluid contains cells from the skin of the foetus and others sources. These cells can be used to determine the sex of the infant, identify some abnormalities in the number of chromosomes and to detect certain biochemicals and enzymatic abnormalities. If it is established that the child is likely to suffer from a serious incurable congenital defect, the mother should get the foetus aborted. 

Misuse:  It is being used to kill the normal female foetus; hence it is legally banned to avoid female foeticide. 

Chorionic villus sampling (CVS): CVS is a prenatal test that involves taking a sample of the placental tissue to test for chromosomal abnormalities.