REPRODCTIVE HEALTH

DEFINITION:
The International Conference Population and Development [1994]
defined reproductive health as “a state of complete physical, mental,
and social well-being and not merely the absence disease or infirmity
in all matters related to the reproductive system and its functions and
processes”.
Included in this definition, is the right of men and women to be informed
and have access to safe, effective, affordable and acceptable method of
family planning of their choice, as well as other methods of theirs for
regulation of fertility, which are not against the law and the right to
appropriate health care services that will enable women to go safely through
pregnancy and childbirth and provide the couple with the best chance of
having a healthy infant.
Reproductive health therefore, implies that people have the ability to
reproduce, to regulate their fertility and to practice and enjoy sexual
relationships.
It further implies that reproduction is carried to a successful outcome
through infant and child survival, growth and healthy development.
It finally implies that women can go through pregnancy and childbirth, that
fertility regulation can be achieved without health hazards and most people
are safe in having sex.

COMPONENTS OF REPRODUCTIVE HEALTH

1. Quality family planning counseling, information, education, and services.

2. Education and services for prenatal care, safe delivery and postnatal care,
including breastfeeding.
3. Prevention and treatment of unsafe abortion and provision of abortion
services where legal.
4. Prevention and appropriate treatment of infertility
5. Treatment of reproductive tract infections and sexually transmitted
diseases, including HIV/AIDS.
6. Information, education, counseling on healthy human sexuality and
responsible parenthood.
7. Discouragement of harmful practices, such as female circumcision or
female genital mutilation
8. Referrals for breast cancer and cancers of the reproductive system,
screening and prevention where applicable and treatment where necessary.
Included are:
9. Gender equity – Deciding freely and responsibly on all aspects of their
sexuality, including protecting and promoting their sexual and reproductive
health.
Be free from discrimination, coercion or violence in their sexual lives in all
sexual decisions, and expect and demand equality, full consent, mutual
respect, and shared responsibility in sexual relationships.
10. Sexual behavior
11. Adolescent reproductive health and sexuality
12. Violence against women
13. Reproductive health of women and men.

INDICATORS OF REPRODUCTIVE HEALTH IN NIGERIA

1. Low contraceptive use prevalence – 10% in 1994, 15% presently.
2. Amongst the highest total fertility rate in the world – 5-8 per woman.
Live births in concrete terms – 35,000 annually
3. Maternal mortality rate of about 1000 per 100,000
Major causes of death in Nigeria are preventable:
4. Unacceptably high child mortality rates or perinatal mortality rates.
For every maternal or child mortality there are several survivors [10 –
15] with one type of debility or the other – they exert stress on the
meager resources of the nation health care.

DETERMINANTS OF REPRODUCTIVE HEALTH IN NIGERIA

- Genetic Constitution
- Socio-economic Development
- Personal Behavior
- Health Care Services

1. GENETIC CONSTITUTION
This unavoidably contributes to reproductive ill-health, e.g. chromosomal
abnormality like Down’s syndrome, Turner’s syndrome, Klinefelter’s
syndrome and sickle cell disease.

2.SOCIO-ECONOMIC DEVELOPMENT
Nigeria is one of the poorest countries in the world [with a gross per capital
income of ]. Most house-hold expenditure is on food, leaving very
little for health care and other social expenditure. There is reduced use of
health care facilities because of relatively high service charges and they
present in hospitals as un-booked emergencies, often times in life-
threatening circumstances.
The exemption of pregnant women from the payment of user fees will go a
long way in reducing the high MMR in Nigeria [Harrison 1997].

3. PERSONAL BEHAVIOR
Breakdown of traditional moral values has led to liberalized sexual
behavior, which has not been accompanied by an increased usage of
contraceptives.
This has led to high prevalence of unwanted pregnancies and abortions,
with their complications.
Unrestricted sexual behavior also results in problem of reproductive tract
infections and STDs leading to infertility.
Harmful traditional practices like FGM, early marriage and childbirth and
rearing all contribute to reproductive ill-health in Nigeria.
Sexual harassment: they do not have choice concerning when, with who and
how to have sex.
Sexually exploited, molested and assaulted under the guise of culture and or
religion.
Trafficking in women for exploitation work, pornography and labor.
Some women require permission from their husbands or male member
before they can visit a health facility.

HEALTH CARE SERVICES

There has been relative decline in funding although in Nigeria the WHO
recommendation of 10% of the national budget is not met, this has affected
curative services, that are largely dependent on equipments from developed
countries.
Available health facilities are not equitably distributed, rural dwellers lack.
So also is the distribution of health personal in the country.

STRATEGIES FOR IMPROVING REPRODUCTIVE HEALTH

1. General Role of Family planning:
Family Planning reduces maternal and infant mortality by preventing
unwanted pregnancies in adolescents [too early], in older women [too
late], in grandmultiparous women [too many] and by ensuring that
babies are well spaced.
It indirectly prevents unsafe abortions and its complications and in some
methods, notably the barrier methods, which prevent spread of STDs.
 Prevention of STDs, post-abortal or puerperal sepsis prevents tubal
disease and infertility.
Family planning also promotes responsible parenthood and improved
sexual relationships.

2. Education and services for antenatal care, safe delivery and postnatal
care, including breastfeeding.

3. Prevention and treatment of unsafe abortion and provision of abortion

services where legal.

4. Prevention and treatment of infertility.

5. Treatment of reproductive tract infections, STDs, including HIV/AIDs.

6. Information, education and counseling on healthy human sexuality and

responsible parenthood.

7. Discouragement of harmful practices, such as female circumcision.

8. Referrals for breast cancer and cancer of the reproductive system.