Concepts: reproductive health, problems and strategies

1.1 What reproductive health means

Reproductive health does not mean only the absence of disease in the reproductive organs. The World Health Organization treats it as complete physical, emotional, behavioural and social well being in everything connected with reproduction. A person in good reproductive health can have a satisfying and safe sex life, can decide whether and when to have children, and has access to the information and services needed to make those choices.

India was one of the first countries to set up a national programme for reproductive health, and the subject is now taught as a separate chapter because these issues touch public health directly. A good note on this section starts from the definition and then lists the problems that the country is still solving.

1.2 The problems

Several problems are grouped together in this section. People of all ages, but especially adolescents, hold myths and misconceptions about sex related matters. Many of them do not know about birth control or about sexually transmitted infections. Sex education is still irregular in schools, so students learn from unreliable sources. Early marriage and early pregnancy put the health of young mothers at risk. Female foeticide is a related problem, and it is made possible by the misuse of tests meant for medical diagnosis.

Reproductive tract infections are common where hygiene and health care are poor. Untreated infections can lead to pelvic inflammatory disease and infertility. Sexually transmitted infections spread when there is no awareness and no protection. Infertile couples face social pressure and rarely know about the treatments available. All these problems are connected to one root cause, which is lack of accurate information and lack of access to services.

1.3 The strategies

The programme for reproductive health uses several strategies together. Awareness is created through schools, media and community groups so that accurate information reaches people before they need it. Sex education in schools is made part of the curriculum, with the hope that adolescents learn to make responsible decisions. Counselling is offered to couples and individuals about contraception, infections, infertility and pregnancy.

Prevention and treatment of reproductive tract infections and sexually transmitted infections need better laboratories, trained staff and low cost medicines. Contraception is offered as a range of choices so that every couple can pick a method suited to its health and its family plans. Prenatal care and safe delivery services lower maternal and infant deaths. Laws against prenatal sex determination and female foeticide are enforced together with education.

A second group of strategies works at the level of the family and the community. Girls are encouraged to stay in school, marriage is delayed, and young couples are counselled before their first pregnancy. Non governmental organisations run centres that explain the options to women in local languages. The important point for an exam answer is that reproductive health needs information, service and law together, and no single strategy is enough.

1.4 Why information comes first

The problems in this chapter look different from each other, yet most of them shrink when accurate information reaches people early. A girl who knows how her cycle works is less likely to be frightened by it and more likely to notice an infection in time. A boy who knows how infections spread is more likely to use protection. A couple that knows the range of contraceptive choices can pick a safe method instead of a permanent one chosen in panic. Counselling is therefore listed as a strategy in its own right, not as a soft add-on.

1.5 A model long answer

A five mark question often asks for the problems and the strategies together. Structure the answer in three parts. First, define reproductive health in one line. Second, group the problems: information problems such as myths and missing sex education, infection problems such as reproductive tract infections and sexually transmitted infections, and social problems such as early marriage, female foeticide and the burden on infertile couples. Third, group the strategies in the same order: awareness and sex education, infection prevention and treatment, and legal and social support including safe pregnancy services and the ban on prenatal sex determination. A grouped answer is easier for the examiner to mark and easier for you to remember.

1.6 A short comparison for revision

The three groups of problems and strategies map onto each other neatly. Information problems need awareness and sex education. Infection problems need early testing, treatment and barrier protection. Social problems need counselling, community support, delayed marriage and strict enforcement of the law against prenatal sex determination. If the examiner asks only for problems, a one line mention of the matching strategy at the end shows that you understand the chapter as a whole, and it often earns the last mark.