PAT DOYLE: I will address the questions, what is reproductive health and why is reproductive health important. I will also describe what aspects of reproductive health we will cover in this particular week of the course. But first of all, I’d like to think about the word reproduction itself. We might start by thinking about biological definitions. Reproduction relates to biological processes by which offspring are produced by parents. Reproduction is a fundamental feature of all known life. The phrase sexual reproduction, in biology at least, describes the process by which a new organism is produced from parents who are different sexes. We can think of reproduction as a lifecycle.
An infant is born, grows into a child, becomes an adolescent, and then an adult who is able to create an infant of their own. It’s important to keep in mind that there are influences on reproduction and reproductive health that can operate across the life cycle. We’ve spoken about reproduction, so what do we mean by reproductive health? A modern definition of health can be thought of as a state of complete physical, mental, and social well-being. It’s not merely the absence of disease or disability. A document written following a UN conference on population and development over 20 years ago, added this particular definition of health to everything related to reproduction.
They included the words, all matters related to the reproductive system, its functions, and its processes. So this is a definition of reproductive health which is wide-ranging and broad. Things we should remember, in particular, are that we need to consider the reproductive health as males as well as females. And that outcomes and influences occur throughout the life cycle, not just in adulthood. Something also to consider, which comes under the umbrella of reproductive health, is sexual health. We can think of sexual health in a similar way. Defining it as a state of physical, emotional, mental, and social well-being in relation to sexuality. It is not merely the absence of disease, dysfunction, or disability.
Sexual health also includes broader issues such as positive and respectful attitudes to sexuality and sexual function. From the WHO report of 2006, other aspects were included in this definition including having pleasurable and safe sexual experiences, which are free of coercion, discrimination, and violence. Although sexual health is included under the broad umbrella of reproductive health, we are not covering sexual health in detail in this course. I’d like now to return to the topic of reproductive health. And the next thing we need to think about is what factors influence or determine good or bad reproductive health. We know that our biology affects reproductive health and so does medical conditions. But we must look at other factors as well.
Social and cultural factors have a major influence.
Examples of social and cultural influences include beliefs, societal norms, or social norms, the relationships between genders, the levels of poverty in any society, the laws operating in a society or country, and finally, the type and availability of services, such as family planning services or maternal services. These all greatly influence reproductive health within an area or a country. So returning now to the idea of the lifecycle, these factors can operate across the lifecycle. For example, female genital cutting in childhood or adolescence, which is determined by social norms and beliefs, can influence sexual function, as well as safe delivery of a baby later in life. This example illustrates the importance of finding out more about reproductive health of a population.
So why is it important to study reproductive health? Well, the ideal for most people is to have a satisfying and safe sex life, and the ability to have a healthy child when, and if, they want to. Many studies have shown that having good reproductive health is also important to achieving a good state of health, in general. In order to help populations attain a good state of reproductive health, we need to know what factors determine good, as well as bad, reproductive health across the lifecycle. And I would like to end this talk by giving you a brief overview of the four main domains in reproductive health.
The definitions we have discussed imply that in order to have good reproductive health, men and women should have a safe and pleasurable sexual life. Women should go safely through pregnancy and childbirth, and couples have the best chance of having a healthy child. Men and women have the lowest possible risk of disease that affects their reproduction. And finally, that men and women are informed of and have access to safe, effective, affordable, and acceptable methods of fertility regulations that they choose. We can expand on these headings to include topics that might be included under them. For example, to have a safe, pleasurable sexual life, it should be free of violence.
In order to bear children safely, we should have services to enable safe delivery. In order to have a healthy reproductive system, ideally it should be free of infection and cancer. And finally, to avoid unwanted births, we should have access to effective contraception or induced abortion. In this week, we will concentrate on this fourth area, that of avoiding unwanted births. And in the steps that follow, my colleagues will outline current knowledge and understanding of contraception, induced abortion, and family planning programmes throughout the world. And one last slide. A more positive term than avoiding unwanted births is every birth wanted.
In order to make every birth a wanted birth, people need to be informed of and have access to safe, effective, affordable, and acceptable forms of fertility regulations which they choose for themselves. That is the aim. Sadly, very few countries achieve this ideal and a lot of work remains to be done.