ИЗМЕНЕНИЕ ТРАДИЦИОННОГО ТИПА РОДОВСПОМОЖЕНИЯ СЕЛЬСКОГО НАСЕЛЕНИЯ АЛТАЙСКОГО КРАЯ В 1918-1950-е гг

Protecting Autonomy of Rohingya Women in Sexual and Reproductive Health Interventions

Illness and health is more often than not, embedded in a matrix of cultural beliefs and is often more than about simply 'being ill' or 'being healthy'. The cause of the 'ill health' may also be located in social and spiritual realms, so that ethnomedical aetiology may include witchcraft and sorcery, and 'attack' by familiars or malevolent spirits. In many communities, constructed understandings of the body and health, for oneself, as well as that of the unborn child, extend back inter-generationally, and point to wider understandings of the (cosmological) world and how the individual is 'located' within this world. Likewise, with many categories of peri-urban and rural African communities, there is an entrenched belief that a pregnant woman and her unborn foetus can be protected from harm, and reproductive health can be promoted by turning to traditional health practices. This paper examines one particular traditional practice; that of offering a decoction known generically as isihlambezo in isiZulu, meant to aid in the delivery of a healthy baby. The paper works through qualitative data gathered from a sample group of pregnant women and traditional healers (sangomas), and probes the popularly constructed meaning of the decoction or isihlambezo. The narratives of the isiZulu participants around isihlambezo, in turn reveal that a complex web of beliefs cohere around understandings of reproductive health and the well-being of the unborn child. These narratives additionally problematise what appears as the hegemonic positioning of the western biomedical discourse which appears to 'push' the faith and reliance on indigenous herbal remedies underground, thus rendering its use somewhat invisible against the more visibly championed western reproductive health care and prenatal medicines.

In Vietnam, great efforts have been made in sexual and reproductive health (SRH) information provision, education, communication, as well as service provision for the adolescent and youth (A&Y) over the last 10 years. This paper aimed to examine the content and implementation of SRH policies for A&Y between 2006 and 2017. Case studies were conducted, including interviews and historical documentation. Qualitative data were collected in Hai Duong, Hue, and Dong Thap provinces through 34 in-depth interviews with representatives of central/provincial agencies and 9 focus group discussions with representatives of communal agencies and beneficiaries. SRH policies for A&Y during 2006 to 2017, along with other related national policies, were developed cohesively, however, the gaps in information provision, education, communication as well as service provision remained unresolved. The contents of policies and program implementation did not cover comprehensively, especially regarding disadvantaged groups such as disabled people, migrants, ethnic minorities, and people aged 10 to 14 years. The A&Y SRH policies and program implementation had faced some challenges relating to governance, service delivery, health workforce, health information system, and health financing. The SRH policy for A&Y in the next period needs to be focused on interventions/services for disadvantaged groups. While the human resource is of great importance for the capacity and feasibility to tackle SRH’s challenges, strengthening the advocacy to ensure policies/programs should be prioritized and committed for effective implementation. An appropriate financing system to run information provision, education, communication, and support services for A&Y must be considered during policy development and implementation.

Sexual health is an important global public health concern. Planning effective strategies to improve sexual health requires a high degree of attention to the local epidemiological trends and cultural context where the strategy is to be implemented. The paper by Chemtob et al. describes the process to develop a plan that aims to reduce the burden of Sexually Transmitted Infections in Israel by 2025. This commentary argues that increased attention to planning and implementation of sexual health policy is required in order to address the real burden of disease. Sexual health should not be merely addressed from a communicable disease control perspective but should comprehensively address health and wellbeing of all population groups through a positive approach in line with the WHO current definition of sexual health. As even traditionally culturally conservative societies are experiencing rapid changes in attitudes and practices towards sexual lifestyles, the challenge is to ensure that sexual health strategies combine evidence-informed measures and good practices with culturally appropriate communication and implementation approaches.

Commentary: Reproductive health and rights in Brazil 20 years post-International Conference on Population and Development

Integration of traditional Chinese medicine with Western medicine - Right or wrong?

Understanding HIV risk and addressing barriers to testing for men who have sex with men in Australia

Purpose This study aims to estimate the degree and nature of socioeconomic-related inequalities in sexual and reproductive health in Ghana and further assesses causes of these inequalities using decomposition technique. The authors assess the contribution of personal characteristics of the woman including access to health information and health seeking behaviours, household and locational characteristics to inequalities in sexual and reproductive health in Ghana. The study uses data from the three rounds of the Ghana Demographic and Health Survey conducted in 2003, 2008 and 2014. Design/methodology/approach Two indicators – use of modern contraceptives and intention to use modern contraceptives – are used to measure sexual and reproductive health of sexually active women. A wealth index, based on household ownership of assets, consumer goods and living conditions, is used as a measure of socioeconomic status. The paper estimates a concentration index to the relationship between cumulative health and socioeconomic rank. Paper procedures to apply decomposition techniques to determine the causes of socioeconomic inequalities in health based on a linear health regression model. Findings The study finds evidence of varying degrees of socioeconomic-related inequalities in sexual and reproductive health indicators. Specifically, the study finds that whilst use of modern contraceptives was concentrated among women in households with high socioeconomic status in 2003 and 2008, modern contraceptive use was prevalent among women in low socioeconomic status households in 2014. Equally, the study finds significant pro-poor inequalities in the intentions to use modern contraceptives in 2003 and 2014. The degree of socioeconomic inequalities in the intentions to use modern contraceptives increased between 2003 and 2014. Originality/value There is the lack of evidence on the degree, nature and causes of socioeconomic-related inequalities, which in tend impedes the design and implementation of sexual and reproductive health policies targeted at vulnerable and under-served populations. In addition, there is the need to study inequalities in health over time to monitor progress of health delivery systems towards equitable and universal coverage and understand the evolution of the determinants.

The concept of sexual health, which was developed at a 1975 conference of the World Health Organization (WHO), is currently being used to set up nationally based public health programs in various countries. I outline the history of sexuality as a public health issue since the 19th century, analyze the history of the concept of sexual health since its emergence in 1975, and make a comparative analysis of the contemporary documents dealing with sexual health generated in the U.S. and England, and by organizations such as the WHO and the Pan American Health Organization (PAHO). The analysis of these documents gives evidence that there is no international consensus on the concept of sexual health and its implementation in public health policies. The conceptions of sexual health remain embedded in national and political contexts. Conceptions for sexual health appear to be the result of political compromises and take place in the public health culture and practice of each country. Depending on the context, these different initiatives focus either on individual responsibility or on an appropriate sexual health services organization, and sexual health may be conceived as an ideal state of well-being or as the reduction of negative consequences of sexual activity.

Background Induced abortion, as a legal medical practice in China, has an enormous negative impact on women’s sexual and reproductive health. After the implementation of the three-child policy, guiding women to choose appropriate contraceptive measures to protect their fertility is the focus of China’s family planning. But little is known about the impact of the family planning policy on women’s contraceptive behaviour. Methods We collected 7022 cases who underwent abortion between July 2020 and June 2022 in Wuhan. Based on the time of implementation of the policy, the study population was divided into two groups, namely, the pre-policy group (before July 2021, Group 1) and the post-policy group (after July 2021, Group 2). Logistic regression was used to analyse the effect of the policy on women’s choice of different contraceptive methods for abortion. Results There were a total of 3487 cases in Group 1, accounting for 49.65%, and 3535 cases in Group 2, accounting for 50.34%. The proportion of women choosing efficient contraceptive methods after the Three-Child Policy decreased compared with before. A correlation was observed between the implementation of the Three-Child Policy and whether to choose efficient contraceptive methods after abortion (p < 0.001). Conclusion The study has found that after the Three-Child Policy, women opting for induced abortion tend to prefer less effective contraceptive methods, particularly condoms. There is a marked shift towards more effective contraception methods both before and after the implementation of the Three-Child Policy.

BackgroundIn Morocco, the national health plan 2025 was developed to promote Sexual and Reproductive Health (SRH) services for all. The principal aim was to achieve the Universal Health Coverage of SRH by 2030. For many years, health authorities’ efforts had focused on reducing maternal mortality through a widespread access to antenatal and obstetric care and family planning services. This has resulted in a significant gap between the availability of SRH components, namely obstetric and family planning care, and access to infertility services including Assisted Reproductive Technology (ART). The objective of this study is to answer two important questions. First, why some SRH programs and services are given priority by international and national political leaders while infertility care receives little attention; second, what are the factors that influence this prioritization?MethodsWe used Shiffman and Smith’s framework composed of four elements: the strength of the actors involved in the initiative, the power of the ideas they use to represent the health problem, the nature of the political contexts in which they operate and the characteristics of the services. We added a fifth element to the framework, the outcome. We applied this framework to the case of infertility services in Morocco. We conducted a desk review and interviews with actors involved in SRH and infertility care advocates as well as with decision makers involved in implementing Universal Health Coverage (UHC).ResultsOur results showed that despite the efforts made by the advocates of infertility care; the enactment in 2019 of a law regulating infertility care services; and the presence of two Assisted Reproductive Technology Units in the public sector, infertility services remain at an early stage of development hampered by multiple challenges. Among others, a lack of political entrepreneurs to ensure a strong leadership; the political windows were often missed; community members lacked consensus on a coherent public positioning of the problem, and advocates' perception and power of the idea lacked evidence and precise indicators of the problem.ConclusionTo ensure the convergence and alignment of all stakeholders, it is recommended to translate the regulation of infertility into measurable activities with defined human and financial resources, equitable fertility health coverage, and quality fertility care to respond to women and infertile couples’ needs, rights and dignity.

Information about state and local education policies regarding sexually transmitted infections, including human immunodeficiency virus, and unintended pregnancy prevention is available, yet less is known about school-level implementation of such policies. We examine trends in the percentage of US secondary schools teaching sexual and reproductive health (SRH) topics in a required course in Grades 6-8 and 9-12, including healthy relationships, sexual abstinence, condoms and condoms with other contraceptive methods. We analyze representative data from 38 states across six cycles of School Health Profiles (2008-18) assessed through self-administered questionnaires completed by lead health teachers. Logistic regression models examined linear trends in the percentages of schools teaching topics for Grades 6-8 and 9-12, separately. Trends were calculated for states having representative data for at least three cycles, including 2018. During 2008-18, it was more common to have increases in teaching how to obtain condoms, correct condom use and use condoms with other contraceptive methods in Grades 6-12 than decreases. More states showed decreases in teaching abstinence in Grades 6-12 than increases. Most states had no change in teaching SRH topics across grades. Findings suggest some improvement in school-based SRH education, yet efforts are needed to improve comprehensive, developmentally appropriate content.

Life saving midwifery knowledge must reach the key influential stakeholders in developing countries if the maternal death rate is to be reduced. The church holds the influence and has the networks and training institutions that can be fully expanded to add sexual reproductive health into their existing studies. This field report documents the author's own sad experiences with maternal deaths in Uganda which has led her toward promoting midwifery knowledge among the church leaders. We have neglected to fully respect culture by avoiding men in our discussions around sex pregnancy birth and family planning. The critical mass of men are our channels to save the mothers, reduce teenage pregnancies, abandoned babies and orphaned children. Christian leaders are the cultural gate keepers and builders of the faith. Our basic training in sexual reproductive health allows men to debate the Bible, their faith, traditional practises and expectations in a safe non-threatening environment. They can then make their own wise decisions about family size. “Without knowledge our people perish.” (Hosea 4:6) If we don’t urgently add the lifesaving knowledge of family planning and Gods wonderful design of our sexuality for true love union we cannot expect to reduce the maternal deaths and overwhelming poverty. Our command is to teach the whole truth because the truth will set us free. (John 8:32).

&lt;p&gt;The availability of reproductive and sexual health services provided by the National Health Insurance (Jaminan Kesehatan National/JKN) in Indonesia could expand women’s access to reproductive and sexual health services. However, the knowledge of community and service provider will determine to what extent women will access the reproductive and sexual health services provided by JKN. This article assesses and analyzes the knowledge of women and health officers about the availability of reproductive and sexual health services provided in JKN. The article elaborates for main findings from the research that was conducted by women organizations that are members of the Women’s Health Care Network (Jaringan Perempuan Peduli Kesehatan or JP2K). JP2K conducted longitudinal research with a series of surveys in 2015, 2016, and 2017 in 15 regions of districts/cities in Indonesia on knowledge and access to reproductive and sexual health services provided by JKN. The surveys show limited knowledge of the respondents, both women and health officers, about forms and scope of reproductive and sexual health services that are covered by JKN. The research concludes that one of the important agendas for encouraging women’s access to health services covered by JKN is through intensifying the socialization of the scope of sexual and reproductive health to women and health facility officers.&lt;/p&gt;

In article are researched peculiarities of mass celebrations setting in 60-80's of XX century in Kyiv. There is established that mass celebrations in Kyiv had mainly state and official character of period. In this regard setting of celebrations (posters, banners, portraits, stands, musical accompaniment and theatrical performance) subordinated to ideological content and had propagandistic trend. The article outlines that Soviet past of Ukraine further largely continues to define our mentality, mode of life, pattern of behavior in society. One of those Soviet remnants in Ukrainian society is some mass celebrations. It is states that in general phenomenon of mass celebrations is an important part of social and cultural realities of our time and used as a communication technology, as a method of consolidation of various communities and way of broadcasting a variety of social ideas. The aim of article is study of specific setting of mass celebrations in Kyiv during Soviet period in 60-80 years of XX century. The most developed in domestic scientific researches is ethno-cultural aspect of holiday phenomenon (V. Borysenko, M. Havryluk, M. Zakovych, S. Zubkov, O. Kurochkin, P. Sokolov, I. Sukhanov). Holiday as a social phenomenon studied Y. Belousov, D. Genkin, K. Zhyhulskyy, A. Mazaev, E. Kaverina, A. Nekrylova, O. Nemyro, A. Piotrowski, V. Propp, S. Turin, D. Uhrynovych, N. Hrenov, O. Shcherbynin, and L. Shumikhina. Specificity of holiday as a symbolic form of culture reveals O. Popravko. In scientific studies of T. Gayevska and J. Slutskaya holidays analyzed as a part of Soviet culture. Some aspects of mass celebrations setting in Eastern Ukraine in 60's and 80's of XX century studied O. Penkova. At beginning article proved that mass celebrations played an important role in Soviet culture. Besides entertainment function they had ideological significance. Soviet ideologists V. Lenin, N. Krupska, A. Lunacharsky and others emphasized importance of consolidation official and national celebrations as a part of cultural state development and ideological activities. Since early 60's of XX century began a new stage in development of mass celebrations, which were caused by profound political changes in Soviet Union after 20th Congress of Communist Party. According to O. Penkova’s research in this period, the state returns to human beings at first time. However, mass celebrations in USSR kept its state and political character. The state established official holidays and was trying to turn them into public tradition. According to Decree of USSR Supreme Soviet About holidays and memorable dates from 1st of October 1980 to category of nationwide celebrations were included anniversary of October Revolution – on 7–8 November, V. Lenin's Birthday – on 22 April, International Day of Worker's Solidarity (Labour Day) – on 1–2 May, Victory Day of Soviet people in Great Patriotic War of 1941–1945 – on 9 May, USSR Constitution Day – on 7 October, National Day of Union of Soviet Socialist Republics – on 30 December, Day of Soviet Army and Navy – on 23 February, International Women's Day – on 8 March. Then article passes to statement that state established official holidays and was trying to turn them into public tradition. The special feature of these key holidays was a clear organization that carried out by apparatus structures of Communist Party. Commissions were engaged in preparation for holiday, which were created in all steps of party vertical. The trade unions, The Young Communist League (komsomol), administrations of enterprises and institutions also carried out decisions of party apparatus. The basic forms of mass celebrations were meetings and demonstrations during 60-80's of XX century in Kyiv. Together with parades of various kinds (military, sports, etc.) they were main forms of expression festive aesthetics of Soviet era. Involvement to celebration of state holidays began with early childhood. The main form of mass state holidays in Kyiv were demonstrations of workers that took place on 7th of November and 1st of May. The celebration of 1500 th anniversary of Kyiv in 1982 became a significant mass celebration in Kyiv in Soviet period as well. In conclusions is revealed that setting of mass celebrations is closely associated with ideological content of Soviet period (the 60-70's of XX century). In Kyiv such mass celebrations as Victory Day, May Day, Day of October Revolution and others necessarily were held in form of meetings and demonstrations. At time of events constantly were used state symbols, portraits of leaders and senior communist party leaders, Heroes of Great Patriotic War and Socialist Labor. In order to ensure solemnity and emotionality in setting of mass celebrations were applied large stands depicting Kyiv emblem or symbols of Kyiv enterprises. Banners with slogans, posters, music of patriotic character, elements of theatrical performances involving athletics and choreographic groups were also widely used.