Sexual and reproductive health
Sexual and reproductive health is a field of research, health care, and social activism that explores the health of an individual's reproductive system and sexual well-being during all stages of their life. Sexual and reproductive health is more commonly defined as sexual and reproductive health and rights, to encompass individual agency to make choices about their sexual and reproductive lives.
The term can also be further defined more broadly within the framework of the World Health Organization's definition of health―as "a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity"―. WHO has a working definition of sexual health as '"…a state of physical, emotional, mental and social well-being in relation to sexuality; it is not merely the absence of disease, dysfunction or infirmity. Sexual health requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having experiences, free of coercion, discrimination and violence. For sexual health to be attained and maintained, the sexual rights of all persons must be respected, protected and fulfilled'." This includes sexual wellbeing, encompassing the ability of an individual to have responsible, satisfying and safe sex and the freedom to decide if, when and how often to do so. UN agencies in particular define sexual and reproductive health as including both physical and psychological well-being vis-à-vis sexuality. Furthermore, the importance of ensuring sexual lives are pleasurable and satisfying, and not only focused on negative consequences of sex has been emphasized by many agencies such as the World Association of Sexual Health as well as considering the positive impacts on health and well-being of safe and satisfying relationships. A further interpretation includes access to sex education, access to safe, effective, affordable and acceptable methods of birth control, as well as access to appropriate health care services, as the ability of women to go safely through pregnancy and childbirth could provide couples with the best chance of having a healthy infant.
The critical Guttmacher-Lancet Commission on Sexual and reproductive health and rights states state Sexual and reproductive health and rights are essential for sustainable development because of their links to gender equality and women's wellbeing, their impact on maternal, newborn, child, and adolescent health, and their roles in shaping future economic development and environmental sustainability. Yet progress towards fulfilling SRHR for all has been stymied because of weak political commitment, inadequate resources, persistent discrimination against women and girls, and an unwillingness to address issues related to sexuality openly and comprehensively. As a result, almost all of the 4·3 billion people of reproductive age worldwide will have inadequate sexual and reproductive health services over the course of their lives''
Individuals face inequalities in reproductive health services. Inequalities vary based on socioeconomic status, education level, age, ethnicity, religion, and resources available in their environment. Low income individuals may lack access to appropriate health services and/or knowledge of how to maintain reproductive health. Additionally, many approaches involving women, families, and local communities as active stakeholders in interventions and strategies to improve reproductive health.
Overview
The WHO assessed in 2008 that "Reproductive and sexual ill-health accounts for 20% of the global burden of ill-health for women, and 14% for men." Reproductive health is a part of sexual and reproductive health and rights. According to the United Nations Population Fund, unmet needs for sexual and reproductive health deprive women of the right to make "crucial choices about their own bodies and futures", affecting family welfare. Women bear and usually nurture children, so their reproductive health is inseparable from gender equality. Denial of such rights also worsens poverty.Adolescent health
creates a major global burden and has a great deal of additional and diverse complications compared to adult reproductive health such as early pregnancy and parenting issues, difficulties accessing contraception and safe abortions, lack of healthcare access, and high rates of HIV, sexually transmitted infections and mental health issues. Each of those can be affected by outside political, economic and socio-cultural influences. For most adolescent females, they have yet to complete their body growth trajectories, therefore adding a pregnancy exposes them to a predisposition to complications. These complications range from anemia, malaria, HIV and other STIs, postpartum bleeding and other postpartum complications, mental health disorders such as depression and suicidal thoughts or attempts. In 2016, adolescent birth rates between the ages of 15–19 was 45 per 1000. In 2014, 1 in 3 experienced sexual violence, and there more than 1.2 million deaths. The top three leading causes of death in females between the ages of 15–19 are maternal conditions 10.1%, self-harm 9.6%, and road conditions 6.1%.The causes of teenage pregnancy are vast and diverse. In developing countries, young women are pressured to marry for different reasons. One reason is to bear children to help with work, another on a dowry system to increase the family's income, another is due to prearranged marriages. These reasons tie back to the financial needs of girls' families, cultural norms, religious beliefs, and external conflicts.
Adolescent pregnancy, especially in developing countries, carries increased health risks, and contributes to maintaining the cycle of poverty. This itself is part of a larger pattern of the inter-generational transmission of the risks associated with poverty and adolescent pregnancy. The availability and type of sex education for teenagers varies in different parts of the world. Teens that are self-identified as non-heterosexual may develop additional problems if they live in places where homosexual activity is socially disapproved or even illegal; in extreme cases, there can be depression, social isolation, and even suicide among LGBT youth.
Maternal health
95% of maternal deaths occur in low income contexts and countries, and in 25 years, the maternal mortality globally dropped to 44%. Statistically, a woman's chance of survival during childbirth is closely tied to her social-economic status, access to healthcare, where she lives geographically, and cultural norms. To compare, a woman dies of complications from childbirth every minute in developing countries versus a total of 1% of total maternal mortality deaths in developed countries. Women in developing countries have little access to family planning services, different cultural practices, lack of information, birthing attendants, prenatal care, birth control, postnatal care, lack of access to health care, and are typically in poverty. In 2015, those in low-income countries had access to antenatal care visits averaged 40% and were preventable. All these reasons led to an increase in the maternal mortality ratio.One of the international Sustainable Development Goals developed by United Nations is to improve maternal health by a targeted 70 deaths per 100,000 live births by 2030. Most models of maternal health encompass family planning, preconception, prenatal, and postnatal care. All care after childbirth recovery is typically excluded, which includes pre-menopause and aging into old age. During childbirth, women typically die from severe bleeding, infections, high blood pressure during pregnancy, delivery complications, or an unsafe abortion. Other reasons can be regional such as complications related to diseases such as malaria and AIDS during pregnancy. The younger the woman is when she gives birth, the more at risk she and her baby are for complications and possible mortality.
There is a significant relationship between the quality of maternal services made available and the greater financial standings of a country. Sub-Saharan Africa and South Asia exemplify this as these regions are significantly deprived of medical staff and affordable health opportunities. Most countries provide for their health services through a combination of funding from government tax revenue and local households. Poorer nations or regions with extremely concentrated wealth can leave citizens on the margins uncared for or overlooked.
However, the lack of proper leadership can result in a nation's public sectors being mishandled or poorly performing despite said nation's resources and standing. In addition, poorer nations funding their medical services through taxes places a greater financial burden on the public and effectively the mothers themselves.
Responsibility and accountability on the part of mental health sectors are strongly emphasized as to what will remedy the poor quality of maternal health globally. The impact of different maternal health interventions across the globe stagger variously and are vastly uneven. This is the result of a lack of political and financial commitment to the issue as most safe motherhood programs internationally have to compete for significant funding. Some resolve that if global survival initiatives were promoted and properly funded it would prove to be mutually beneficial for the international community. Investing in maternal health would ultimately advance several issues such as gender inequality, poverty, and general global health standards. As it currently stands, pregnant women are subjugated to high financial costs throughout the duration of their term internationally which is highly taxing and strenuous.
In addition, if either parent has a genetic disease, there is risk of these being passed on to the children. Birth control or technical solutions can be an option then.