Reproductive Health(RH)
By: Michael A.(BSc, MPH/RH)
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Session Overview
◼ Learning Objectives
◼ Historical development of RH-global and Ethiopia perspective
◼ Definition of RH and SH
◼ Objectives of RH
◼ Components of RH care
◼ SRH rights
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Learning objectives
◼ At the end of this session students are able to:
❑ Describe historical development of RH
❑ Define and differentiate reproductive health + sexual health
❑ Identify Objectives of RH
❑ Identify the different components of RH
❑ Discuss SRH rights
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Historical development …
◼ 1954 -The impact of rapid Population growth becomes an agenda
❑ 1st international conference was held in Rome
◼ 1965-The 2nd conference was held in Belgrade
◼ 1974- Bucurest Population Conference
◼ 1978 Alma Ata deceleration of primary health care- MCH one of the 8
components
◼ 1970s and 1980s- Population policies became widespread in developing
countries
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Historical development …
◼ 1984- Mexico City Population Conference – Need “Fertility Regulation”
reduce mortality + death rate
◼ Early 1980s by UNICEF and others promote GOBI-FFF
❑ Growth monitoring
❑ Oral rehydration
❑ Breast feeding
❑ Immunization
❑ Female education
❑ Family planning/family spacing
❑ Food supplements
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Historical development …
◼ 1986- the lancet published Where is the “M” in MCH?
◼ 1987- The safe motherhood conference was carried out
in Nairobi to correct this inequity.
◼ What were the consequences / the outcomes of these
approaches ?
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Historical development …
◼ Consequence of 70-80s approaches – Key Outcomes:
• Free standing family planning “institutions” were established
• Vertical approach, with distinct administrative, financial, training
and supervisory structures
• Family planning targets based on number of new acceptors
• Haynes Human rights violations, e.g :
• Involuntary sterilization
• One child policy in China
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Historical development …
• Key global movements / responses to these outcomes:
• Emerging Opposition to ‘target driven’ approach increased:
• International women’s movement: freedom of choice and right to decide
• Health professionals vs. population experts: reproductive health beyond
fertility regulation
• HIV and AIDS pandemic- necessity to respond to sexual activity
beyond pregnancy, and urgency to understand social and behavioral
context of health
What did this urgency lead to
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Historical development …
◼ 1990s Health Sector Reforms, decentralization, community participations
◼ 1994 International Conference on Population and Development (ICPD)
Cairo Consensus
◼ 1995 Beijing Conference (4th World Conference on Women)
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Historical development …
◼ 2000 Millennium Development Goals (MDGs)
2006 Maputo plan of action
2009 ICPD +10
2010 Millennium Summit
2014 ICPD beyond 2014
2015 Sustainable Development Goals (SDGs)
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ICPD – Major shifts in focus
❑ From “numbers” (supply-driven) to “needs” (demand-driven)
❑ From “population control” to “free choice” – more holistic approach
❑ From the limited concept of FP/MCH to the broader concept of SRH:
◼ New issues on the agenda include emergency contraception, (post-)abortion care,
reproductive cancers, female genital mutilation, sexual harassment, etc.
❑ Right-based approach adopted – paradigm shift from family planning and
demography to the right if the individual
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ICPD – Major shifts in focus…
◼ Stronger emphasis on women and gender
❑ Recognition gender equality, empowerment, women control their own
fertility/body
❑ Full participation
❑ Eradication of discrimination on grounds of sex
❑ Role of men/male involvement
◼ “New” target groups ( e.g. young people ,all women married or not, people
living with HIV, IDPs, refugees)
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Historical development of RH in Ethiopia
1993- National Population Policy
1993- Health Policy
1998-HIV/AIDS Policy
2003- Health Extension Program (HEP)
2004 -National Youth Policy
2005 - National RH strategy, 2006 – 2015
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Historical development of RH in Ethiopia ..
2007 - National AYRH strategy, 2007 – 2015
2007 - Standards and minimum service package on
Youth Friendly RH Services, (, MOH)
2010- GTP 2011/12-2014/15
2015- HSTP 2015/16-2019/20
Know a day RH become one of the top priority
issues in our country
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Definition of RH
◼ How do you define RH?
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RH vs SH
RH SH
◼ RH is sate of complete physical, mental and ◼ Sexual health is a state of
social well being not merely the absence of physical, emotional, mental,
disease or infirmity in all matters related to and social wellbeing in
the reproductive system and in its functions relation to sexuality
and its process
◼ Sexual health needs a
◼ It implies that people are able to have a positive and respectful
responsible, satisfying and safe sex life, the approach to sexuality and
capability to reproduce the freedom to sexual relationships
decide if, when and how often to do so.
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RH vs SH
RH SH
◼ Implicit in this are the right of men ◼ Pleasurable and safe sexual
and women to be informed of and experiences that are free of
to have access to: coercion, discrimination, and
❑ Safe, effective, affordable and violence
acceptable methods of fertility ◼ The sexual rights of all individuals
regulation
respected, protected, and satisfied
❑ Appropriate health care services
enabling safe pregnancy and childbirth
and the best chance of having a healthy
infant.
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◼ What is Reproductive health care?
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Reproductive health care :definition
Reproductive health care;
◼ is the constellation of
❑ methods,
❑ techniques and
❑ services
◼ that contribute to reproductive health and well-being by;
❑ preventing and
❑ solving reproductive health problems
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Objectives of RH
1. Ensure that comprehensive & factual information & a full
range of RH services, including FP are
◼ accessible,
◼ acceptable &
◼ convenient for users
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Objectives…
2. Enable support on responsible voluntary decisions about
child bearing & methods of FP of their choice,
3. meet the changing sexual & RH needs over the life-cycle
& to do so in ways sensitive to the diversity of
circumstances of local communities.
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What are the components of RH care?
Information, education
and counseling on human
Maternal Health sexuality, reproductive
Family planning
• Prenatal care health and responsible
IEC/BCC,
• Delivery care parenthood
Counseling
• PNC
Services
• Neonatal care
including BF
Prevention of unsafe abortion
and management of
Treatment of reproductive complications and
Active tract infections, sexually
discouragement of consequences
transmitted diseases,
harmful traditional including HIV/AIDS and
practices cervical cancer
Safe abortion
services when not Prevention and
against the law appropriate treatment
of infertility
Referral Linkage for all the services
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Reproductive Health Rights
The right to:
1. Life, liberty and security
2. Health, RH and FP Services
3. Decide the number & spacing of ones children
4. Consent to & equality in marriage
5. Privacy
6. Be free from discrimination
7. Modify traditions and customs that violet the right of women
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Reproductive Health Rights
8. Not to be subjected to torture or other cruel form of human
treatment
9. Be free from sexual violence
10. Information and education
11. Enjoy scientific progress and to consent to experimentation
12. Freedom of assembly & political participation.
Source: Human Rights and ICPD
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Sexual Rights
◼ They include the right of all individuals to
1. free of coercion, discrimination and violence
2. The highest attainable standard of sexual health,
3. Seek, receive, and impart IEC related to sexuality;
4. Choose their partner;
5. Decide whether or not to be sexually active;
6. Consensual sexual relations & marriage;
7. Pursue a satisfying, safe and pleasurable sexual life.
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Application of Human Right to SRH
Right to life:
- No mother should lost her life for the sake of reproduction
- The fetus starting from conceived zygote has the right to survive
and would be born.
– Promote Safe motherhood and advocate against Maternal Mortality
and Morbidity
– Infanticide, Genocide, and Violence
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Application of Human Right to SRH
Right to Liberty & Security of the Person
– Protection of women and children from:
– sexual harassment, sexual abuse
– female genital mutilation
Right to be Free from all forms of discrimination
– Discrimination with regard to access to SRH services
– Discrimination which denies legal protection against violence
– Campaign for laws which prohibit discrimination against women and their
effective enforcement
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Application of Human Right to SRH. . .
Right to Information and Education:
– youth access to information and education
– programs which enable service users to make decisions on the basis
of full, free, and informed consent
– discourage programs which do not give full information on the
relative benefits, risks, and effectiveness of all methods of fertility
regulation
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Application of Human Right . . .
Right to be Free from Torture and Ill Treatment
– protection of women and children from sexual exploitation,
prostitution
– protection of women and children sexual abuse, coercion in any
sexual activity, and domestic violence
– legislation which prohibit abortion on the grounds of rape.
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Thank you
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