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Suggested Citation:"INDEX." National Research Council. 1997. Reproductive Health in Developing Countries: Expanding Dimensions, Building Solutions. Washington, DC: The National Academies Press. doi: 10.17226/5500.
×

Index

A

Abortion

access to, 108-109

access to contraception and, 112

care for complications of, 112

data collection, 114-115

extent of unsafe practice, 95-96

for gender selection, 109-110

legality, 108-109, 112

maternal morbidity and mortality, 95, 96, 118

as measure of unwanted pregnancy, 95

quality of care, 109

reducing iatrogenic infection in, 6, 72

septic, 79, 80

service linkages, 158

sex-selective, 110

strategies for improving safety, 7

techniques, 109

training of health care professionals, 109

utilization, 2, 15, 95

Accountability, 10, 187

Adolescents

norms for sexual behavior, 25, 26-27

initiation of sexual activity, 64-65

pelvic inflammatory disease risk, 54

Africa, 14

access to maternity care, 130, 131, 138

AIDS/HIV prevalence, 2

fears of STD, 24

female genital mutilation, 32, 33

gender differences in postpartum sex, 22-24

infertility prevalence, 87

maternity care, 139-140

pregnancy outcomes, 116

programs for promoting healthy sexuality, 39

public awareness of contraception methods, 106

reproductive tract disease, 45, 46-48

sexual behavior standards, 28

sexual violence, 30

unmet need for contraception, 100-101

unwanted or mistimed births, 6, 89

Suggested Citation:"INDEX." National Research Council. 1997. Reproductive Health in Developing Countries: Expanding Dimensions, Building Solutions. Washington, DC: The National Academies Press. doi: 10.17226/5500.
×

Agency for International Development, U.S., 1

AIDS/HIV

case management, 76

counseling and testing, 69-70

in developed countries, 44-45

in developing countries, 48

educational interventions, 36, 65-66

in pregnancy, 58

prevalence, 2

recommendations for clinical services, 81-82

risk factors, 2

Anemia

pregnancy complications, 120-121

prenatal care, 9, 125-126

Asia, 14

access to maternity care, 131, 137, 138

female genital mutilation, 32

maternal mortality, 116

reproductive tract disease, 46, 47

sex-selective abortion, 110

sexual behavior standards, 25, 27

sexual violence, 30

B

Birth. See Delivery and neonatal care

C

Cancer, 18

cervical, screening for, 80

RTI-related, 58-59

Caribbean basin, 14

access to maternity care, 131

sexual violence, 30

Chancroid, 47

Children, sexual exploitation of, 32

Chlamydia, 43, 44, 47, 54, 55, 57, 77, 128

Circumcision, female. See Female genital mutilation

Circumcision, male, 51, 71

Client-oriented, provider-efficient (COPE) assessment, 82, 105

Commercial sex

condom promotion, 69

cultural trends and, 29

heath risks for workers, 30

sociocultural differences, 29

STD prevention strategies, 67

STD screening, 5

Contraception

abortion demand and, 112

access, 6-7, 103-104

condom promotion, 4

current service delivery, 147-150

demand for subsidized services, 110-111

effects on STDs, 51

emergency methods, 102-103

estimates of unmet need, 100-102

policy obstacles to, 112

as prevention of abortion complications, 96-97

public awareness and understanding, 106-108

quality of family planning services, 103-106

side effects, 107

social marketing, 4, 69, 108

technical innovation, 102

unwanted birth prevalence and, 89, 94-95

user adherence and compliance, 104-105

utilization, 103

women's concerns, 37

women's sexual rights and, 24

women's social status as determinant of, 111-112

COPE assessment, 82, 105

See also Family planning services

Costs

administrative costs, 10

future prospects, 195

health-seeking behavior in pregnancy and, 273

models for estimating, 192-193, 279-294

policy decisions, 188-189

Suggested Citation:"INDEX." National Research Council. 1997. Reproductive Health in Developing Countries: Expanding Dimensions, Building Solutions. Washington, DC: The National Academies Press. doi: 10.17226/5500.
×

quality of contraception services and, 104

rationale for reproductive health services, 11

research, 178

STD interventions, 60

subsidization of contraception, 110-111

training costs, 194

See also Contraception

Cost-effectiveness analysis, 189-192, 193, 195

disability-adjusted life year measures, 190-192

D

Delivery and neonatal care

access to care, 130-131, 136-138, 269-273

anemia complications, 120-121

birthing homes for, 144

bleeding symptoms, 134

clinical protocols, 144-145

current program capacity and utilization, 146-150

effective programs, 269-273

essential care, 129-130

family role, 141-142

genital herpes complications, 121-122

genital herpes intervention, 57-58

gonorrhea complications, 57

health-seeking behaviors, 135-136, 261-269

HIV transmission and, 58

maternity waiting homes for, 143-144

obstetric fistula complications and intervention, 121

obstructed or prolonged labor, 128

partograph monitoring, 128

pathways to maternal survival, 132, 140

quality of care, 7-8, 138-140, 144-145, 273-276

recognition of complications, 8-9, 132-135, 141-142, 257-261

role of traditional birth attendants, 141-42, 261-269

RTI risks, 55

settings for 130, 135-136

syphilis intervention, 5-6, 128

user fees for, 187-188

See also Pregnancy and birth;

Prenatal care

Demand for services, 10, 105, 164-166

Disability-adjusted life year measures, 190-192

E

Eclampsia and pre-eclampsia, 126-127

Ectopic pregnancy, 80

Educational interventions

in family planning programs, 107-108

for healthy sexuality, 2-3, 35-37

to improve obstetric quality of care, 8-9

to influence fertility behavior, 111, 112

for STD prevention, 65-66

Essential care for obstetric

complications, 129-130

Europe, RTIs in, 43, 44-45

Expenditures

current health care spending, 178, 179

current reproductive health spending, 179-182

F

Family planning services

client criteria for evaluating, 103

current capacity and utilization, 146-150

current public-sector spending, 179-180

Suggested Citation:"INDEX." National Research Council. 1997. Reproductive Health in Developing Countries: Expanding Dimensions, Building Solutions. Washington, DC: The National Academies Press. doi: 10.17226/5500.
×

dissemination of contraception information, 106-108

external financial assistance, 181-182

future challenges, 100

generating demand for services, 164-165

in integrated reproductive health services, 105, 155-163

opportunities to improve contraception services, 100-103

policymaking environment, 110-112

quality of contraception services, 103-106

reproductive health goals, 85

RTI prevention and treatment, 81-82, 105-106

STD management strategies, 4-5

Female genital mutilation

health risks, 3, 33

incidence and prevalence, 3, 32, 33

interventions against, 3

procedure, 32-33

rationale, 3, 32

research needs, 35

trends, 39

Fertility

family size, 88, 95, 97

global patterns, 116, 150

Financing

private sector support, 11

public-private collaboration, 184-186

rationale for public sector financing, 182-183, 195

rationing of services, 189

resources for, 154

sources and distribution of external assistance, 181-182

user fees for, 11, 186-188

G

Gonococcal infection

newborn prophylaxis, 5-6, 78, 128

pelvic inflammatory disease risk, 53-54

in pregnancy, 55-57

prevalence in developed countries, 43-44

prevalence in developing countries, 46-47

screening, 77

H

Health care professionals

access to, for maternity care, 130-131, 136-138, 142-143

outreach activities, 165

training costs, 194

training for abortion procedures, 109

training for maternity care, 144, 262-269

training for obstetric and neonatal care, 8

training for prevention of iatrogenic RTI, 71-72

Health-seeking behaviors, 10

cultural norms for sexual behavior as obstacle to, 25, 26-27

generating demand for reproductive health services, 10, 105, 164-166

maternity care, 135-136, 141-142, 261-269

postpartum care, 131

reproductive tract infection, 74

risk of reproductive tract infection, 51

sexual problems, 37

Healthy People 2000, 166

Herpes, genital, 44, 48, 57-58

HIV. See AIDS/HIV

Human papilloma virus, 44, 58

Human rights, 18

Hypertension

maternal mortality, 118

prenatal care, 9, 126-127

Suggested Citation:"INDEX." National Research Council. 1997. Reproductive Health in Developing Countries: Expanding Dimensions, Building Solutions. Washington, DC: The National Academies Press. doi: 10.17226/5500.
×

I

Infant morbidity and mortality

consequences of unwanted pregnancy, 97-99

global patterns, 2, 16, 150

gonococcal eye infection, 5-6, 253

low birth-weight infants, 123

pregnancy outcomes, 122-123

prenatal care benefits, 124

prenatal pathways to prevention, 132

reproductive tract infection and, 55, 57, 58

risk factors in labor, 128

Infertility

global patterns, 54, 87

RTI and, 54-55, 87

International Conference on Population and Development (ICPD), 1, 13, 14, 85, 110, 111, 166, 173

L

Latin America, 14

access to maternity care, 131, 137, 138

demographic trends, 16

quality of maternity care, 139, 140

sex education, 35, 36, 39

sexual violence, 30, 31

unwanted or mistimed births, 89

Legal issues

access to abortion, 108-109

care for complications of illegal abortion, 112

changes for promoting healthy sexuality, 39

conceptualization of sexual violence, 31

cultural perspectives on divorce, 22

legal access for sexual violence victims, 3

obstacles to contraception access, 112

right to refuse sexual relations, 22

M

Malaria, 18-19, 158-160

Maternal mortality

abortion-related, 96, 118

access to care and, 16, 142-144

anemia-related, 120, 125-126

causes, 7, 118

definition, 118

essential care for prevention, 129-130

global patterns, 2, 15, 150

historical trends, 129-130

hypertension-related, 126-127

labor-related, 128

medical audit, 276

pathways to prevention, 132, 140

points of intervention in pregnancy, 123

pregnancy and, 96, 116-118

preventive strategies, 7-8, 123-124, 129-130

risk assessment for medical complications, 124-125, 141-142

tetanus-related, 127-128

Media campaigns

consideration of local values, 38

contraception, 108

for health sexuality, 37-38

social marketing, 4, 69, 108

STD prevention, 4

Mexican example, 173-174

Middle East

female genital mutilation, 32

sexual behavior standards, 22, 25, 27

unwanted or mistimed births, 89

Midwifery, 8, 130, 143, 144, 269

Mother-Baby Package, 154, 192-193, 280-294

N

Neonatal care. See Delivery and neonatal care

North America

reproductive tract infections, 43-45

unwanted/mistimed births, 93-95

Suggested Citation:"INDEX." National Research Council. 1997. Reproductive Health in Developing Countries: Expanding Dimensions, Building Solutions. Washington, DC: The National Academies Press. doi: 10.17226/5500.
×

P

Pacific Islands, 14, 30

Pelvic inflammatory disease, 53-54, 55, 249-253

Performance monitoring, 152-153

Population growth, 16-17

Poverty

rationale for public financing of health care, 183

RTI risk, 53

Pregnancy and birth

clinical protocols, 144-145

cultural influences on reproductive decision-making, 88

global patterns, 15

infant morbidity and mortality, 16, 122-123, 152

integrated reproductive health services, 9-10, 155-163

international comparison of outcomes, 150

maternal disabilities, 118-122

maternal mortality, 2, 15, 96, 116-118

See also Delivery and neonatal care;

Maternal mortality;

Unwanted or mistimed births

Prenatal care

access to, 130-131, 150

anemia complications, 120, 125-126

benefits, 124

bleeding symptoms, 134

for complications of existing disorders, 119

current program capacity and utilization, 146-150

ectopic pregnancy, 80

effective programs, 270-271

family role, 141-142

genital herpes intervention, 57-58

goals, 123

gonorrhea complications, 55-57

hypertension complications, 9, 118, 126-127

maternal mortality and, 116-118, 123-124

psychosocial support, 260-261

risk assessment, 124-125

standards of care, 9

STD screening and intervention, 5-6.

See also specific diseases

syphilis intervention, 5-6, 9, 57, 128

user fees for, 187-188

See also Delivery and neonatal care;

Pregnancy and birth

Private sector activities, 11

delivery of publicly-financed health care, 184-186

user fees, 188

Program design and implementation

accountability, 10

administrative structure, 152, 160, 161

breadth of services, 154-158

current capacity and utilization, 146-150

decentralization, 163-164

demographic-specific delivery, 162-163

determinants of success, 152

focused commitment to objectives, 152-153

future needs, 9, 16

gender orientation, 15

for healthy sexuality, 34-38

integrated delivery of services, 9-10, 37, 105, 155-163

limitations of RTI interventions, 60-62

mass treatment for STD, 78-79

maternity care, 7-9, 140-145, 257-276

national priorities and, 188-189

need for experimentation and research, 9, 19

obstacles to evaluation, 62

organizational structure, 155

performance of large-scale programs, 150-152

private delivery of publicly-financed care, 184-186

public sector role, 182, 186, 194

reform strategy, 166-173

Suggested Citation:"INDEX." National Research Council. 1997. Reproductive Health in Developing Countries: Expanding Dimensions, Building Solutions. Washington, DC: The National Academies Press. doi: 10.17226/5500.
×

reproductive health goals, 13-14, 166-167

sex education, 2-3, 35-37

STD management, 4-5

STD prevention, 4

vertical organization, 158-160

See also Family planning services

Prostitution. See Commercial sex

Public awareness and understanding

of contraception methods, 106-107

generating demand for health services, 10, 164-166

healthy sexuality education campaigns, 37-38

recognition of pregnancy complications, 132-135

STD prevention strategies, 65-66

Q

Quality control, 105

Quality of care

in abortion, 109

contraception services, 103-106

maternity services, 138-140, 144-145, 273-276

prenatal services, 7-9

quality assurance programs, 105

user fees and, 187

Quality of contraception services, 103-106

R

Reproductive health

barriers to, 16-17

global threats to, 1-2

goals, 1, 13, 14, 85, 166-167

life-cycle perspective, 18

morbidity/mortality, 15-16

rights issues, 18

women's health and, 15

Reproductive tract infection (RTI)

causes, 3, 40

consequence of, 4, 40, 53-55

current service capacity, 150

data quality, 42-43, 61-62

design and implementation of interventions, 4-6, 59-61

effects on sexual behavior, 37

evaluation of interventions, 61-62, 81

family planning services in controlling, 105-106

generating demand for services, 164

health behavior risk factors, 51

health-seeking behaviors, 74

iatrogenic, 6, 40, 63-64, 71-72

infertility and, 54-55

integrated service infrastructure, 161-162

interactions of risk mediators, 48-49

levels of preventive intervention, 62

management strategies for prevention, 73-77

neoplasias related to, 58-59

physiological microenvironment risk factors, 49-50

pregnancy outcomes and, 55-58

prenatal screening, 9, 57

prevalence in developed countries, 43-45

prevalence in developing countries, 45-48

primary prevention strategies, 63-72

recommendations for clinical services, 80-83

research priorities, 83-84

secondary prevention strategies, 72-73

sexual behavior risk factors, 50-51

sexual norms as obstacle to help-seeking, 26-27

sociocultural risk factors, 52-53

tertiary prevention strategies, 79-80

trends, 40-42

RTI. See Reproductive tract infection

S

Salpingitis, 53, 54, 249

Screening programs

cervical cancer, 80

for hypertension in pregnancy, 127

prenatal and neonatal, 5-6, 9, 57

Suggested Citation:"INDEX." National Research Council. 1997. Reproductive Health in Developing Countries: Expanding Dimensions, Building Solutions. Washington, DC: The National Academies Press. doi: 10.17226/5500.
×

sex-selective abortion and, 109-110

for STD in sex workers, 5

STD preventive interventions, 69-70, 75-76, 77-78

Sexual behavior. See Sexuality

Sexual violence

child sexual exploitation, 32

health risks of, 31

mortality, 30

prevalence, 30

service needs, 3

sociocultural context, 30, 31

against spouse, cultural perspectives in, 22

Sexuality

abstinence, 24

adolescent, 25, 26-27

AIDS/HIV risk, 2

autonomy in, 20, 21, 38

condom promotion, 4, 68-69, 81-82

cultural context, 2, 20-30

dynamics of partner selection, 66-67

dysfunction, 18

encouraging safer practices, 67-68

gender differences in postpartum sex, 22-24

gender-specific concerns, 37

healthy, 2, 20

initiation of sexual activity, 64-65

need for educational interventions, 2-3, 35-37

norms, 20-21

number of partners, 65

program design for promoting healthy sexuality, 34, 37

public information campaigns, 37-38

reproductive health and, 20, 37

research needs, 34-35

right to refuse sexual relations, 21-24

right to seek sexual relations, 24-29

risk screening, 75-76

RTI prevention strategies, 64-69

RTI risk, 50-51

sex education and, 36

trends in premarital relations, 25-26, 28-29

See also Sexually transmitted disease

Sexually transmitted disease (STD)

adolescent sexual behavior and, 26-27

assessment of lower abdominal pain, 249-253

assessment of urethral discharge, 236-239

behavioral risk assessment, 75-76

chemical barriers, 70-71

condom use and, 51, 68-69

counseling and testing interventions, 69-70

diagnostic procedures, 74, 76, 77-78

educational interventions, 65-66

evaluation of preventive interventions, 60

genital ulcers, 239-240

incidence, 2, 15

inguinal bubo, 240-243

integrated reproductive health services, 9-10, 37, 155-163

male circumcision and, 51, 71

management interventions, 4-5

mass treatment approaches, 78-79

partner notification programs, 78

prenatal and delivery care, 5-6

prevalence in developed countries, 43-45

prevalence in developing countries, 45-48

preventive interventions, 4

rationale for public intervention, 182-183

refusal of sex for fear of, 24

reproductive risks, 2

screening for sex workers, 5

scrotal swelling, 243-245

targeting of interventions, 59-60

treatment algorithms and protocols, 5, 73-77, 235

vaginal discharge, 245-249

women's health and, 15

World Health Organization treatment recommendations, 235

See also Reproductive tract infection;

specific disease

Suggested Citation:"INDEX." National Research Council. 1997. Reproductive Health in Developing Countries: Expanding Dimensions, Building Solutions. Washington, DC: The National Academies Press. doi: 10.17226/5500.
×

Sociocultural context

complications of pregnancy, 121-122

divorce and separation, 22

family size decisions, 88, 97

implications for healthy sexuality programs, 34, 38

premarital sexual relations, 25, 28-29

recognition of pregnancy and postpartum complications, 133, 134, 141-142

RTI risk, 52-53

seeking maternity care, 135-136

sexual violence, 3, 30, 31

sexuality in, 2, 20-30

significance of, 14

utilization of postpartum care, 131

women's social status, 38

STD. See Sexually transmitted disease

Substance use, 49

Suicide, 30

Syphilis

in pregnancy, 57, 128

prenatal screening, 5-6, 9, 57, 128

prevalence in developed countries, 43

prevalence in developing countries, 45-46

screening for, 77

T

Tetanus, 127-128

Trichomoniasis, 47

U

Ugandan example, 175-177

Unwanted or mistimed births

abortion as indicator of, 95-96

access to contraception and, 94-95

consequences for infants and children, 97-99

consequences for mother, 96-97

consequences for wanted children, 99-100

contraceptive practices correlated with, 89

definitions, 86, 97

determinants, 93-95

direct measures, 89-90, 114

indirect measures, 93

measurement methodology, 86-87

measurement of intentionality, 87-88, 101, 113-114

as percentage of total births, 1, 6, 15

policymaking environment, 110-112

rate, 89, 90

rationale for preventive intervention, 6

rationale for reducing, 99-100

social support for, 100

Urbanization, 17, 193

User fees, 11

benefits of, 187, 195

charged by nongovernmental organizations, 188

current practice, 186-187

effects on service delivery, 187, 188, 194-195

for maternity care, 187-188

rationale, 187

sliding scale, 187

W

Women's issues

contraceptive use, 37

economic and social status, 38

genital mutilation, 3

interventions against sexual violence, 3

reproductive health and, 15

right to refuse sexual relations, 21-24

right to seek sexual relations, 24-29

sexual norms as obstacle to health, 25, 26-27

social status and fertility behavior, 111-112

World Health Organization, 235

Suggested Citation:"INDEX." National Research Council. 1997. Reproductive Health in Developing Countries: Expanding Dimensions, Building Solutions. Washington, DC: The National Academies Press. doi: 10.17226/5500.
×
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Suggested Citation:"INDEX." National Research Council. 1997. Reproductive Health in Developing Countries: Expanding Dimensions, Building Solutions. Washington, DC: The National Academies Press. doi: 10.17226/5500.
×

Selected Publications, Committee on Population

Available from the National Academy Press (2101 Constitution Avenue, N.W., Washington, D.C. 20418; 1-800-624-6242 or 1-202-334-3313); available on-line at http://www.nap.edu.

Preventing and Mitigating AIDS in Sub-Saharan Africa: Research and Data Priorities for the Social and Behavioral Sciences. J. Trussell and B. Cohen, eds. 1996.

Social Dynamics of Adolescent Fertility in Sub-Saharan Africa. C.H. Bledsoe and B. Cohen, eds. 1993.

Effects of Health Programs on Child Mortality in Sub-Saharan Africa . D.C. Ewbank and J.N. Gribble, eds. 1993.

Factors Affecting Contraceptive Use in Sub-Saharan Africa. Working Group on Factors Affecting Contraceptive Use. 1993.

The Epidemiological Transition: Policy and Planning Implications for Developing Countries, Workshop Proceedings. J.N. Gribble and S.H. Preston, eds. 1993.

Developing New Contraceptives: Obstacles and Opportunities. Institute of Medicine, L. Mastroianni, Jr., P.J. Donaldson, and T.T. Kane, eds. 1990.

Suggested Citation:"INDEX." National Research Council. 1997. Reproductive Health in Developing Countries: Expanding Dimensions, Building Solutions. Washington, DC: The National Academies Press. doi: 10.17226/5500.
×

Contraception and Reproduction: Health Consequences for Women and Children in the Developing World. Working Group on the Health Consequences of Contraceptive Use and Controlled Fertility. 1989.

Contraceptive Use and Controlled Fertility: Health Issues for Women and Children. A.M. Parnell, ed. 1989.

Available from the Committee on Population (National Research Council, 2101 Constitution Avenue, N.W., Washington, D.C. 20418; phone: 202-334-3167, fax: 202-334-3768, email: cpop@nas.edu. Also available online at http://www.nap.edu.

Data Priorities for Population and Health in Developing Countries. C.E. Malanick, and A.R. Pebley, eds. 1996.

Reproductive Health Interventions: Report of a Meeting. J.G. Haaga, A.O. Tsui, and J. Wasserheit, eds. 1996.

Resource Allocation for Family Planning in Developing Countries: Report of a Meeting. J.G. Haaga and A.O. Tsui, eds. 1995.

Organizing for Effective Family Planning Programs. R.J. Lapham and G.B. Simmons, eds. 1987.

Available from Plenum Press (233 Spring Street, New York, N.Y., 10013-1578):

Demographic and Programmatic Consequences of Contraceptive Innovations. S.J. Seagull, AO. Sui, and SM. Rogers, eds. 1989.

Suggested Citation:"INDEX." National Research Council. 1997. Reproductive Health in Developing Countries: Expanding Dimensions, Building Solutions. Washington, DC: The National Academies Press. doi: 10.17226/5500.
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Sexually transmitted diseases, unintended pregnancies, infertility, and other reproductive problems are a growing concern around the world, especially in developing countries. Reproductive Health in Developing Countries describes the magnitude of these problems and what is known about the effectiveness of interventions in the following areas:

  • Infection-free sex. Immediate priorities for combating sexually transmitted and reproductive tract diseases are identified.
  • Intended pregnancies and births. The panel reports on the state of family planning and ways to provide services.
  • Healthy pregnancy and delivery. The book explores the myths and substantive socio-economic problems that underlie maternal deaths.
  • Healthy sexuality. Such issues as sexual violence and the practice of female genital mutilation are discussed in terms of the cultural contexts in which they occur.

Addressing the design and delivery of reproductive health services, this volume presents lessons learned from past programs and offers principles for deciding how to spend limited available funds.

Reproductive Health in Developing Countries will be of special interest to policymakers, health care professionals, and researchers working on reproductive issues in the developing world.

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