Category Archives: Reproductive Health

Sexually Transmitted and Reproductive Tract infections

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The issue of breastfeeding is a crucial one for pregnant women living with HIV. In many developing nations they have a tough choice: either breastfeed their babies and risk transmitting the virus through their milk, or give them formula. The latter deprives infants of the natural immunity passed on through breast milk which helps protect against diarrhoea, malnutrition and other potentially deadly diseases. Sanitation can also be an issue, with a scarcity of clean water with which to mix the formula and, in any case, many may not be able to afford to buy it in the first place. Preventing mothers from dying and babies becoming infected with HIV is one of the nine priority focus areas for UNAIDS and its Cosponsors under the Joint action for results: UNAIDS outcome framework 2009-2011.

Michel Sidibé, UNAIDS Executive Director, has championed this priority and said during a recent visit to Lesotho in Southern Africa, “Strengthened services for maternal health, for reproductive health and for paediatric health will mean we can prevent mothers from dying and babies from becoming infected with HIV in Lesotho and around the world.”  The findings from the Kesho Bora study will now be considered by WHO experts, along with other recent data, and the 2006 WHO recommendations on the use of ARVs in pregnant women and on infant feeding and the prevention of mother-to-child transmission will be reviewed in the context of this new evidence. Updated guidelines are expected to be published before the end of the year.

It is clear that this research increases the range of treatment options available to mothers living with the virus and offers them hope that, if they so wish, they have a greater chance of breastfeeding their babies without passing on HIV.

Reproductive Health for the 21st Century

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The National Institute of Child Health and Human Development (NICHD) seeks to ensure that every individual is born healthy, is born wanted, and has the opportunity to fulfil his or her potential for a productive life unhampered by disease or disability. The Institute further strives to help parents have the children they want, at the times they want them, and to ensure that every mother experiences a pregnancy free of adverse complications. Key to the success of this mission is answering the fundamental questions of how a single fertilized cell eventually develops into a fully functional adult human being and how a multitude of genetic and environmental factors influence that process for good or ill. Programs at the NICHD are based on the concepts that adult health and well-being are determined in large part by episodes early in life, sometimes before birth; that human development is continuous throughout life; and that optimal outcomes of development are important not only to the individual but to society. NICHD research is also directed toward restoring or maximizing individual potential and functional capacity when disease, injury, or a chronic disorder intervenes in the developmental process. Thus, the NICHD mission truly spans the life cycle, and much of the health and well-being of our population depends on the success of the Institute’s research.

 

During 1998 and 1999, the NICHD staff engaged the scientific community in jointly developing a strategic plan to facilitate achieving its mission. The initial framework document for this plan, From Cells to Selves, highlighted four areas for immediate strategic development and described a series of scientific goals under each area. This is one of four areas was as follows: Reproductive Health for the 21st Century comprises the biological and behavioural factors that allow couples to have healthy children when they want them and the reproduction-related conditions that may affect women during and after their reproductive years.

Reproductive Health Treatment

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The ability to control one’s own reproduction encompasses the desire not only to have children but also to have them at a time and in a manner that best ensures their future health, both physical and mental. Reproductive health significantly influences the overall health of individuals and society and has been the subject of increased attention from a health and economic viewpoint. The economic burden imposed on infertile couples attempting to achieve pregnancy is difficult to estimate accurately because the cost of treatment is not always reported as infertility related.

The projected direct cost of assisted reproductive technologies (ART) together with the cost of multiple-gestation pregnancies is estimated to be $1.1 billion for the year 2000. The direct cost of unintended adolescent pregnancies alone is more than $1.5 billion. Thus, the overall costs of infertility treatment and those of all unintended pregnancies would substantially exceed $3 billion annually. These direct costs are in addition to the considerable indirect costs associated with the immediate and long-term psychological and other consequences that accompany both conditions. In addition, the direct and indirect costs associated with uncontrolled population growth worldwide are difficult to comprehend, let alone quantify. Consequently, it is critical to address these problems from the broadest possible perspective.

During the past decade, major advances have been made in both the biomedical and behavioural sciences that can be applied to the important issues of infertility treatment, to the development of improved methods of family planning, and to the identification of behavioural factors that affect both fertility and infertility. The Institute’s strategic plan builds on this solid research base.

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