Sexual and Reproductive Health in China

Databases of PubMed, Scopus, and China National Knowledge Infrastructure (CNKI) were used to search relevant articles on sexual and reproductive health (SRH) in China published from 2005 to the present (2021), based on the World Health Organization’s (WHO) Operational Framework on Sexual Health and Its Linkages to Reproductive Health. The following results were found. (a) SRH education and information among the Chinese were insufficient, in particular regarding contraception, pregnancy, and sexually transmitted diseases (STDs). Adolescents, migrants, and the rural population had insufficient knowledge of SRH. (b) Fertility care services were mainly available in large cities, in urban areas, and for married couples. Services targeted for rural-to-urban migrants, rural residents, and the disabled and elderly are needed. (c) A total of 22.4% of youths aged 15–24 had premarital sexual intercourse, and the age of first sexual intercourse was decreasing. Risky sexual behaviors included multiple partners, casual and commercial sex, and having sex after drinking alcohol. (d) The contraceptive practice rate of women aged 15–49 in China was higher than the world’s corresponding figure. However, contraceptive use among young people was low (only 32.3% among unmarried women). (e) Unmarried pregnancy induced by low contraceptive practice is a critical issue in China. (f) Induced abortion was the major consequence of unmarried pregnancy. The rate of induced abortion among the general population in 2016 was 28.13‰, and the rate among unmarried women was increasing annually. (g) There were 958,000 HIV-infected cases in China as of October 2019. Sexual transmission was the major transmission route of HIV-AIDS. More men than women were infected. Men having sex with men comprised the high-risk group of sexual transmission of HIV-AIDS. (h) Gender-based violence including intimate partner violence (IPV), sexual violence, sexual coercion, and child sexual abuse (CSA) might be underreported in China, since many victims were afraid to seek help as well as due to limited services. Legal and regulatory measures should therefore be taken to prevent and reduce gender-based violence. For future perspectives of SRH in China, it is important to pay attention to SRH education and services. An up-to-date national survey on SRH is needed to reflect the current situation and to capture changes over the past decade. Most of the current research has been conducted among adolescents, and more studies are needed among other groups, such as the disabled, the elderly, and homosexual populations.

Spatial Variation in Contraceptive Practice Across the Districts of India, 1998–2016

India is currently one of the most demographically diverse regions of the world. Fertility and mortality rates are known to show considerable variation at the level of regions, states and districts. Little is known however, about the spatial variations of the contraceptive usage—a critical variable that is relevant to fertility as well as health policy. This paper uses data from four national population-based household surveys conducted between 1998 and 2016 to explore district-level variations in the contraceptive prevalence rate. We find no clear evidence of convergence. The gap between the best and worst performing districts is more than 70 percent across the four rounds and does not diminish over time. We also find considerable evidence of spatial clustering across districts. Districts with high prevalence concentrate in Southern states and more recently, in the Northeast of the country. Our analysis suggests that female literacy and health care infrastructure are important correlates of spatial clusters. This suggests that investments in women’s human capital and health-care infrastructure play a role in expanding women’s opportunities to time their births.

Varriation In Utilization of Modern Contraceptive Among Married Women In The Seven Woredas of Assosa Zone: A Comparison of Bayesian and Classical Approach. Case Study In Assosa Zone, Benishangul Gumuz , Ethiopia

Introduction: Contraception is a procedure that can be used to avoid pregnancy or childbirth. When women choose to prevent pregnancy or have a longer birth, they frequently use contraceptives. The global prevalence rate of contraceptive use was 64 percent, with Africa responsible for 33 percent. Ethiopia has an estimated rate of 39.2 percent of its population engaging in this activity.Objectives: This study was aimed to identify the predictors of married women’s contraceptive practice using Bayesian and classical approach. In addition, this study has identified the within and between Woredas variation using the hierarchical nature of the data obtained in different woredas. For identifying the better model, researcher has compared the Bayesian and classical multilevel logistic regression models. Methods: This research was conducted in seven Woredas of Assosa zone and was based on a cross-sectional study that primarily focused on married women between the ages of 15 and 49 and the factors that influenced their contraceptive use. Two stage model comparisons were used to approximate the parameters, with the first stage having a null, random intercept, and random slope with a Bayesian approachResult and Conclusion: The overall contraceptive prevalence rate among 6866 married women 3121(45.46%). According to the intra Woreda correlation of the appropriate model, the between Woreda variance in married women's contraceptive practice was 15.71%, with the remaining 84.29 percent variation attributed to differences in contraceptive practice between women. Finally, predictors for married women contraceptive practice such as women's age, place of residence, women's educational level, husband's educational level, women's job, husband's occupation, wealth index, religion, and knowledge of family planning. The Bayesian multilevel model was found to be the most suitable model for fitting the data after a comparison of classical and Bayesian multilevel models.

Complication of Menstrual Regulation (MR)-A Study On It's Clinical Presentation And Outcome

Background: Menstrual regulation is the aspiration of endometrial content within 14 days from the missed period or within 42 days from the last menstrual period having previous normal cycles. So embryonic implantation either can not occur or can not be maintained.This technique is also known as menstrual aspiration, menstrual extraction, interception and uterine aspiration.This technique was first developed in 1927. In spite of its safety and effectiveness, to some extent it is contributory to some minor and major complications. Objective: The aim of this study was to determine the clinical presentation and outcome of the complication of menstrual regulation (MR). Materials and Methods:This cross sectional prospective study was done in Obs.&Gynae department of Dhaka Medical College Hospital, from November 2008 to February 2009. This study was on MR complications, it's clinical presentation and outcome. The cases diagnosed by history, examination and investigation. Results: Total number of Gynaecology admission was 1680 out of which 5.71% was due to MR complications . 89.58 % were multipara . In 77.07% cases gestational age was between 7 to 9 wks, in 52.08% cases MR was performed in private chamber. 12.5% patients suffered from p/v bleeding,2.08% suffered from shock and acute abdomen due to visceral injury. In 9.37% cases required abdominal surgery . Death was recorded in 2.08% cases. Conclusion: To reduce the incidence of complications, contraceptive practice should be popular and available to the community and MR service should be used as back up service when needed. KYAMC Journal Vol. 11, No.-4, January 2021, Page 208-211

Methodological analysis of period fertility in Saudi Arabia 2018

Exact measurement and evaluation of indicators of period fertility in a multiracial society could help explaining disparities. This paper represents a methodological and analytical attempt to systematically analyze period fertility and discuss differentials in its level and pattern between domestic and expatriate women in Saudi Arabia as far as available data allow. The data used are obtained from official Sources published by General Authority for Statistics in the Household Health Survey 2018. Estimated period fertility indicators, started from the simplest rates to the more elegant ones with adequate illustration of the advantages and disadvantages of each of them. The purpose was to establish fertility differentials and historical pattern. The paper has consistently shown that the fertility of expatriates in Saudi Arabia is lower than the fertility of the Saudi domestic women, but the reason for the disparity was not established as contraceptive practice has not confirmed sufficient influence. It was also revealed that the fertility transition that had been taking place since early eighties will continue but it will have precautions in the future.

Female Sterilization in Costa Rica, 1940 to 2020

Sterilization is an increasingly familiar phenomenon to women worldwide, and it is the most prevalent contraceptive practice in the world. Costa Rica, where the use of contraceptives is generalized, is among those countries in the world with the highest prevalence of female sterilization. In Costa Rica, female sterilization is homogeneously distributed, common among women living in rural and urban zones, as well as among those of diverse educational levels. In contrast to what one may expect given the legacy of abusive birth control practices in Latin America, the “problem” of sterilization in Costa Rica has been framed by women and doctors alike not as the “need” for curbing its use but rather as a “struggle” for broadening access as much as possible. Interestingly, current rates of sterilization have been attained in the absence of a formal program offering sterilization for contraceptive purposes and in the context of a very restrictive legal framework for its provision. It was not until July 1999 that sterilization for contraceptive purposes was explicitly regulated and permitted. Before that year, it was only so-called therapeutic sterilization that was legally allowed. Sterilization was supposed to be offered only for health reasons. Notably, successive moves intended precisely to broaden access to this surgery within the state hospital system have been realized through regulation formally restricting its provision. This sometimes counterintuitive history of the provision and regulation of sterilization in Costa Rica is analyzed.

Sociodemographic Profile, Contraceptive Practice and Awareness of HIV Infection among Unmarried Postpartum Women in a Tertiary Centre in Malaysia

Introduction: To describe the sociodemographic profile, contraceptive practice, and awareness of HIV infection among unmarried post partum women in the biggest government hospital in Pahang. Methods: A cross sectional questionnaire-proforma-based study was conducted for one year duration from August 2010 until July 2011 by identifying and recruiting all the unmarried women upon admission for delivery. Basic information were obtained from the use of patients’ case notes, and further related and necessary information were obtained from a direct face-to-face interview based on a proforma. Results: A total of 121 unmarried women were identified and recruited. The age ranged from 13 to 36 years with a mean age of 21.6 years. 31.4% were teenagers. Only 16% of patients have tertiary education, and 2.5% never had any formal education. About one third of the women were smokers or ex-smokers, 7.5% had consumed alcohol, but none denied ever use of any recreational drugs. Almost 9% has prior history of being sexually assaulted. About three quarter of the women never used any contraceptive method. Majority of the patients (85.1%) were aware of HIV transmission risk; 75% never had any antenatal checkup or booked at late gestation (> 20 weeks); and 45.8% were not aware of any support groups for single mothers. Conclusion: Single unmarried women are associated with disadvantaged sociodemographic profile. Contraceptive practice was also very low despite significant awareness towards risk of HIV infection. Further follow up, support and care should be offered to these women.

Male Contraceptive Behavior in Rajshahi District of Bangladesh

This article examines the actual scenario of male involvement either as a user of contraceptive methods or supportive reproductive partners of women on contraceptive use in Rajshahi district of Bangladesh. The analysis shows that, knowledge and use of contraception are low in our study area. Comparative figures of contraceptive practice between men and women found a large disparity. Findings reveal that the user rate of all male contraceptive methods (e.g., condom at 17 percent) is still low compared to that of female methods (pill at 33.8 percent), which shows that men like to impose contra ceptive responsibility on women. Identification of socio-economic and demographic differentials affecting contraceptive behavior of men is performed through the technique of logistic regression. This paper elucidates that education, residence, fertility preference, mass media facility and knowledge about AIDS are the significant factors to influence contraceptive practices among men. Regarding the factors shunning the contraceptive practice we found that men’s opposition to use contraceptive methods is as most significant. The next reason for not using is related to contraceptive method.