Strategies for Improving Reproductive Health

Worldwide, the number of women of reproductive age is projected to increase by more than 250 million between 2000 and 2015, from 1.56 billion to 1.82 billion. Given the need for protection against disease and the growing desire of women—and men—to delay pregnancy and have smaller families, such projections represent a challenge to the world’s nations at a time whey they seem ill-prepared to increase services proportionately.

Nevertheless, the vast disparities in reproductive health worldwide and the greater vulnerability of the poor to reproductive risk point to several steps all governments can take, with the support of other sectors, to improve the health of women and their families.

• Give women more life choices. The low social and economic status of women and girls sets the stage for poor reproductive health. Societies need to address broader development needs and unequal access to resources. Efforts must be made to expand access to education for girls and women and to economic opportunity and its rewards.
• Invest in reproductive health care. Removing the physical, financial, and cultural barriers to available services is an important first step in the provision of quality care. A commitment to improving the sexual and reproductive health of women and men requires that communities, governments and international donors fund these programs and services adequately and consistently.
• Encourage delays in the onset of sexual activity and first births. To reach young people, provide them with complete and accurate sexual health information and affordable and youth-friendly family planning services and counseling. Youth-friendly services that work to overcome barriers—such as the lack of specially trained health personnel, inconvenient hours, lack of confidentiality and costs—are increasingly common.
• Help couples prevent and manage unwanted childbearing. Better access to high quality family planning, including information and services for emergency contraception, helps prevent unwanted pregnancies. Reducing unsafe abortion involves promoting hygienic practices where abortion is legal, providing post-abortion care for treatment of complications of unsafe abortion, and providing family planning counseling and services.
• Ensure universal access to maternal health care. Good quality maternal health care includes a range of services during pregnancy and at and after childbirth. These include promotion of proper maternal nutrition, attendance at delivery by skilled health personnel, detection and management of complications before, during and after delivery, and access to emergency obstetric care.
• Support new reproductive health technologies. Microbicides are being developed that would protect women against sexually transmitted infections (STIs). More varied and better contraceptive methods, including male and barrier methods, are necessary to meet the increasing and widely varying needs of the world's couples. Female condoms present women with an additional means of protecting themselves against STIs, including HIV, but remain largely unaffordable when available at all. Emergency contraception could help women avoid unintended pregnancy, but is all but unknown to women and health providers in most of the world.
• Increase efforts to address the HIV pandemic. In the absence of a vaccine, preventive measures such as sexual health education and provision of barrier methods remain the most effective and affordable interventions available to slow the HIV pandemic. There is an urgent need for promoting and developing methods that women can control. Such strategies are central to a comprehensive approach to minimizing the human tragedy of HIV/AIDS.
• Involve communities. Community participation is essential in developing, implementing and evaluating programs, if they are to be sustainable and effective.
• Forge partnerships. Developing partnerships within communities and across sectors—including the private sector (both non-profit and for-profit), policymakers and aid donors—can broaden support for better reproductive health.
• Measure progress. Collecting reliable data to monitor and evaluate reproductive health programs is a challenge to resource-strapped countries, particularly with respect to maternal mortality and morbidity. Governments can monitor their progress by using alternative means of measurement, such as tracking information on the use and quality of maternal health services provided. .

The availability of reproductive health services, including family planning, can help couples realize their childbearing intentions and help assure that reproduction is healthy and safe. The preventive aspects of reproductive health services gain even more importance in light of the HIV pandemicUltimately, good sexual and reproductive health benefits everyone and its consequences extend from the family to the entire planet.