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Department
Health
Course
HLTH 101
Professor
an/a
Semester
Summer

Description
Topic 1 Monday, October 31, 2005 7:03 PM Topic 1 - Introduction to Sexual and Reproductive Health Definitions Sexual health It is the capacity for enjoyment of sexif you live a life where you dont enjoy ittheres something wrong with you An ability to control your sexual and reproductive behaviour This concept encompasses a lot of thingssuch as rape you dont have control! Or how about if you want to have sex, but you cant? Freedom from: Fear, shame, guilt, and false beliefs So whats a false belief? Its not talking about how Christians believe that you shouldnt have sex unless youre married False beliefs instead are like, If you masturbate youll go blind Shame and guilt: its not that you should never feel shame and guilt for ANYTHING Freedom also from: Organic disorders, diseases, and deficiencies We should treat things that relate to sex! i.e. Fertility treatmentswhy shouldnt we be entitled to them? Yet we complain about dealing with it Healthy Sexuality It is a positive and life-affirming part of being human This includes: Knowledge of yourself and others Opportunities For example, no privacy in nursing homesor actively stopping Capacity for intimacy Our attitudes about sexuality, our ability to understand and accept our own sexuality (the quote is on the website somewhere) Reproductive Capacity Its a fundamental part of our being! Later on it becomes more importantfertility issues are a big source of health care dollar expenditure today! Our biological capacity to reproduce, and our expectations (quote on site) Issues in Sexual and Reproductive Health in Canada Teen pregnancy rates This is an enormous health problemeven if it doesnt affect us personally, we pay for it! Personally, through our taxes And also that we dont get tax dollars used on us because theyre being used on the health problems of teen pregnant mothers and their children This is prevalent even in developed countries High rates of low-birthweight infants This is especially bad in low-income groups The fact that we dont prevent all LBW is mostly because of no political will Sexually transmitted diseases HIV, AIDS, etc. This is especially a problem in young people However that is changingsince Viagra came on the market, middle-aged women are having more STDs! The economic burden of this was $36 billion in 1999 (for all STDs) Infertility About 7% of couples (more if you restrict age) Canadians spend around $30 million on in-vitro fertilization (a lot of this is private dollars) Sexual abuse/family violence The health related cost for violence against women and children is $1.54 billion/year Issues in Sexual and Reproductive Health Globally Maternal mortality Maternal mortality is usually unnecessary! We have the skills to handle the situation! So whenever it happenswe want to find out why However, that is not the case in the developing world By the way, maternal mortality is defined as death due to complications of pregnancy or childbirth In 2000what was the deal with MM? In the developing world, it is < 20 / 100,000 live births So this is already quite lowand they are probably preventable still That wasnt always the casein the Victorian Age in England it was around 10%! Howeverin sub-Saharan Africait is 920/100,000 live births Again, all of these cases were probably preventable if they had access to the resources we have! In the developing world in general (so more than sub-Saharan Africa), there are about 500,000 maternal deaths per year It associated with high rates of teenage pregnancies (if you are a teenager, there is a 2X rate of maternal mortality) This is because your body at that age is designed to grownot to have a baby! So what are the things associated with MM (in descending order): No skilled attendant at delivery (i.e. a mid-wife) Low literacy rates Not having an institution (hospital/clinic/birthing center) to deliver your baby in Not having available contraception Ante-natal care (so we are talking about both pre and post-birth) The GNP (gross national product)the lower the countrys GNP, the higher the mortality rates Note: literacy rates seem to be a determinant of all these other factors anyway! Some think that it is a CAUSAL factor of things like GNP Severe maternal morbidity So this means the mother doesnt diebut there are SEVERE health consequences If you have high MM, you probably also have high maternal morbidity! Perinatal mortality Also very highly correlated to the top 2similar causal factors, etc. Unsafe abortions Before, abortions were self-inducedyou can eat stuff that causes the body not to want to continue with the pregnancyhowever they also have a good chance of killing the mother But now in the developing world (specifically sub-Saharan Africa), doctors do itand thats actually how they make a lot of their income! Many doctors are untrainedand so they might not even do it right! In 1994, there was a study in Kinshasa, Zaire 15% of women there had an abortion They found it was correlated with education the more educated you are, the more likely you are to have had an abortion Pregnant girls must often leave school! Thats why you have to abort the baby if you want to continue with your education HIV / AIDS There are FEW effective programs in the developing world for HIV/AIDS There are many cultural barriers to overcome! In Africa, there are MORE THAN 25 million people dead from AIDS 12 million orphans! More than 3 million NEW cases of HIV per year! Most people will die from thisunless they die of something else first In South Africa, more than 6 million people are infected, and 600 people die per day Other sexually transmitted diseases Infertility Cervical cancers Genital mutilation This is only starting to be a problem in Canada As our borders are more fluid and we get people from elsewhere in the world, we see more people who have had this done! Unmet family planning needs Its hard to plan your family size in Africaits hard to control your reproductive rateand therefore, the rates of abortion are high! Contraception is unavailable in much of the developing world In sub-Saharan Africa (2000): 5-6 births/woman on average The use of contraception is correlated with educationif you are educated, you are more likely to be able to get to it Determinants of Sexual and Reproductive Health Social and Economic Environment For example: Income, SES (socioeconomic status), social support, education, employment, and working conditions Low SES is associated with: Earlier sexual activity Increased risky sexual practices (i.e. without a condom) Increased risk of tee
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