National Prevention Strategy-Reproductive & Sexual Health

National Prevention Strategy-Reproductive & Sexual Health

Introduction

Healthy reproductive and sexual practices play a critical role in enabling people to remain healthy and active in their contribution to the community. Planning and healthy pregnancy are essential to the health of women and infants, and adolescents in the community (Frost et al., 2013). Positive sexuality and healthy sexuality are government priorities. As sexual beings, positive sexual identities are fundamental to a sense of sexual well being and the ability to lead a fulfilling life. The sexual problems have long time consequences in the case of HIV infection and consequence is death. Unintended pregnancies are preventable, as adolescent pregnancy not only creates social economic problems for the mothers, as increases the risks of poor outcome in education, health and welfare. The federal government intends to improve service delivery. Increasing access to comprehensive preconception and prenatal care for the low-income risk women aims at improving health. The government also intends to do research and disseminate ways that would effectively prevent premature birth and sudden infant death syndrome.

The federal government also intends to promote and disseminate best practices and tools to reduce behavioral risk factors such as sexual violence, alcohol and other drug use. There is a need for national prevention, sexual duplicate and health strategy. The United States has had success in maintenance of low prevalence of transmission of HIV. Some of the programs have gone forward to address the issues related to unintended pregnancy, with the success emanating from the ongoing commitment to addressing the issues (Kirchengast, 2012). The issues also affect different communities at different levels. Therefore, the strategy put in place needs to focus on the population specific actions. It is also essential to address the issues affecting heterosexuals such as the increased prevalence of HIV transmission amongst the group.

Sexual and reproductive health in the United States: current situation

The reproductive health indicators show relative high mortality and increased levels of maternal and infant mortality rates. There are also increasing incidences of sexually transmitted infections increased abortion rates with low prevalence of contraceptive use (Frost et al., 2013). Within the disproportionate, burden of ill health in the society, there are some of the populations that are at higher risks.  One of the greatest consent lies amongst the adolescents. A large proportion of the adolescents have induced abortions, an increase in the Sexually Transmitted Diseases (STDs) affecting the groups largely. The migrants also constitute the other population with higher risks of reproductive morbidity. This leads to increased levels of unwanted pregnancies with increased risks of induced abortions and obstetric complications. The migrants also have a higher risk of HIV infection and transmission of STDs because they are forced into unprotected sexual relationships. Furthermore, there is also increasing in the violence against women due to the increase levels of sexual assault such as rape.

The national preventive strategy aims at addressing the key barriers to the reduced health disparities hence ultimately improving the health of Americans. Reproductive and sexual health, especially the spread of STDs and the prevalence of the unintended pregnancies are majorly determined by the social, economic and behavioral factors. One of the major barriers to people accessing reproductive and sexual health is the stigma associated with it. For instance, the continued stigma around associated with HIV positive people can prevent people from being tested and knowing their status. The other factors include individuals’ reproductive and sexual health decision making includes the limited access to medical care, social amenities and the prevalence of high alcohol dependence on alcohol and drugs.

National Prevention Strategy-Reproductive & Sexual Health action plan

A broad range of social and behavioral factors influences sexual behaviors, hence their reproductive health. Most of the demographic factors change over time, influencing certain stages of growth and development in life.  For example, in the United States people have tended to start a family at a later stage in life, the result of increased levels of instability in relationships. This consequently increases the number of sexual partners and therefore the increased risks of acquiring sexually transmitted diseases. In addition, the preference for starting a family at later stage has necessitated prolonged use of reversible birth control methods, which could have detrimental impacts in the future.  Because of the changing social characteristics, it implies that there is a need to update and improve the strategies and approaches to the sexual and reproductive health. Because of the constant change on behavioral and environmental factors, it is important to focus the preventive strategies on the reducing of the predisposing factors. Estimates of 19 million recent cases of sexually transmitted diseases are diagnosed annually in the United States. The majority of these cases affect young people at their prime age of 15 years to 24 (Brownson et al., 2010). Over 1.1 million Americans live with HIV virus, and one out of five individuals does not know their status. The following factors can lead to long-term reproductive health improvement.

  1. a) Change in community attitudes, values and behaviors

Increasing awareness and understanding of all members of society about the complex nature of sexuality, sexual behaviors and motivation are critical. This could be achieved through the exploration of societal views and aspiration for sexual and reproductive health. It is critical to explore the role of communities in improvement of sexual reproductive health. This is achieved through focusing on determinants of sexual reproductive health, including the societal issues and the power imbalances in relationships. Through the increase in the ability of families and caregivers to support children and young people to make a healthy sexual and reproductive health decisions for themselves, improves the health. The government has also made efforts to address the negative attitudes towards the disabled people, parents and the other professionals (Ivankovich, 2013). Determining issues faced with disabilities for the disabled people related to their sexuality, sexual and reproductive needs addressed.

The community’s attitude, social and cultural values as well as media representations can have significant impacts negatively and positively on sexual behaviors. The society has the responsibility of creating a supportive social environment. Therefore, the strategy intends to promote the rights of every American citizen, on their decisions about sexual behaviors free from discrimination, violence whilst promoting their welfare for partners and children. The communities have to be engaged in identifying problems and desired outcomes in their own, prioritizing their concerns through the planning and implementation of programs to address the concerns. The preventive strategy helps in addressing issues relating to power, race, gender and cultural complexities.  Education and health promotion programs and service sectors are designed to encourage sexual behaviors between partners promoting positive sexuality.

  1. b) Education on individual knowledge, ability and behaviors

Increasing the individual’s understanding and skills and teach them to value themselves of personal identity and self-worth. This intends to ensure appropriate health education across the lifespan with the aims of increasing healthy sexuality and reproductive health choices. Individuals need to have personal skills as well as social skills enable them to exercise more control over their own health. The development of personal skills enables them to negotiate for safer sex such as the use of condom. The national preventive strategy has put in place mechanisms to improve social skills and sexuality education which starts early in childhood. This ensures that the children have an understanding of their different body parts. Practical information and social skills development should continue so that young people can make healthy decisions for themselves. The disabled children and adolescents are at risk of of missing their social skills, development of sexuality education. The lack of knowledge and skills to practice safe sex may contribute to the increasing numbers of unintended pregnancies. All of the population groups need information about their sexual health as well as safer sexual practices.  The factors affecting sexual behaviors include young age, low educational attainment and drug abuse. The effects of loneliness need to feel care, passion, fun and acknowledgement.

The teenagers who get pregnant at tender age face the risks of dropping out of school.   Half of the teenage mothers get their high school diploma by the age of 22, compared to the 90 percent of the teen girls who do not give birth. On the other hand, half of the teenage fathers with children before 18 years complete their high school on time getting their GED by the age of 22 years (Brownson et al., 2010). Older adults are overlooked population in the reproductive and sexual health. However, the situation is changing as the majority of the population is changing in the United States. For example, 29% of the people living with AIDS are over the age of 50, with older women being at a higher risk of contracting HIV and other sexually transmitted diseases (Ivankovich, 2013). This is because of vaginal thinning and dryness, which could cause tearing of the vaginal areas. In addition, some of the older adults may be less knowledgeable about HIV and AIDS; therefore, they are less likely to protect themselves. They do not perceive themselves to the risks of contracting HIV and therefore do not use protection.

  1. c) Improvement of healthcare service delivery

The prevention intends to ensure that the sector development and the interventions and services work in harmony to improve sexual and reproductive health. The services should provide accessible, appropriate primary specialist health services.  It should also ensure that the services are non-discriminative, and responsive to their diverse society, gender, ethnicity and orientation sexual practices (Ensor & Cooper, 2004).  In addition, the services need to create an environment through which the service providers can work in collaboration integration and in the primary health care. The services also ensure that the workforce development occurs with an increase in staff numbers and improvements consistent with the strategy.

The preventive strategy ensures that primary services continuously delivered in a variety of sites. For example, general practitioner teams, family planning, and population specific non-governmental organizations achieve this through erection of a hospital based health care service. The services also ensure that there is easy access to products and supplies including treatment for specific infections, the easy access of condoms and contraceptives. The primary focus means improvements to sexual reproductive health services, aimed at improving the quality of access to services and service delivery. It is therefore essential to minimize costs as a barrier to the delivery of services to make the services affordable. Furthermore, better integration and linkage between the existing reproductive health services and the sexual health services have to be encouraged.

  1. d) Provide effective sexual health education, especially for the adolescents

Development of medically accurate and appropriate sexual health education provides people with the skills and resources to make responsible choices.  Educating the adolescents could delay their initiation to sexual behaviors in adults including the seniors. Effective sexual health education, monitoring programs and the other evidence-based activities can lower the risks associated with unintended pregnancies and reduce the risks associated with communication decision making and the need to foster relationships free of sexual violence. Ongoing programs for home visitation transform the lives of mothers and their babies. The trained professionals provide low-income first time mothers get the support that they need to have a healthy pregnancy. This ensures that the mothers provide responsible and competent care for their children, helping them become economically self-sufficient.

Accurate and timely information are increasingly seen an essential health tool for improvement of clinical and professional practices. Since the range of services is limited and widely varied, the information has to be readily available to the community. Information can also assist in the understanding of cultural aspects of unwanted and unintended pregnancies. Quality information can assist in the development of best practices and guidelines to oversee experiences made relevant to issues amongst all the citizens. The program seeks to maintain, improve and monitor the surveillance systems by ensuring the appropriate information is collected. The preventive strategy seeks to undertake the relevant research, evaluation of the strategy ensures confidentiality and the information is not identifiable.

  1. e) Enhance early detection of HIV, Hepatitis, and STDs with improved linkage to care

Routine screening can enhance early detection of HIV, Hepatitis, Chlamydia and the other sexually transmitted diseases. Linking people to treatment reduces transmission and improves the health of the people living with HIV. For example, administration of antiretroviral therapy is 92 percent less likely to transmit HIV to others (Hoggart & Phillips, 2011). Early identification and treatment of HIV and chronic viral infections and common STIs such as gonorrhea cured with a single treatment. Increasing access to and fostering linkages between health care and community systems, especially those provide low cost services to improve early detection and treatment.

The World Health Organization (WHO) has made reproductive health a priority area underlined in the World Health Organization Resolution passed in 1995. The resolution seeks the member states to further develop and strengthen their reproductive health programs.  It seeks to ensure that there is improved access in reproductive health needs through the development of medium and long-term guiding principles on the lines elaborated by the WHO. The mandate is to specifically, increase their attention on equity perspectives and participation of the individuals who needs service for the internationally recognized human rights principles (Kirchengast, 2012).

Reproductive and sexual health is important for most of the women at their childbearing age. For the infants, the babies of the mothers who do not get access to the prenatal care have a higher likelihood of having low birth weight, with an increased likelihood of increased mortality. Reproductive health is also significant for the adolescents. This is because at the adolescent age, STDs are more prevalent associated with the increased risks. From the previous research, approximately half of the new STDs infections occur amongst the young people. The determinants of the reproductive and sexual health should be monitored closely to ensure an increase in the use of preconception and prenatal care (Centers for Disease Control and Prevention, 2011).

Future implications of reproductive and sexual health management

The reproductive health management helps in the detection and control of reproductive health conditions early. For instance, the prenatal care can help in the detection of gestational diabetes before it causes problems. Taking prenatal vitamins can help in the prevention of birth defects of the brain and spinal cord. In addition, the national prevention strategy also aims at increasing the detection and management of Sexually Transmitted Diseases. If the STDs are not treated, it could lead to long-term health consequences for the adolescents and women. This is because the STDs could lead to the decrease in fertility rate. The Centre for Disease Control and Prevention (CDC) estimates that the poor control and treatment of STDs cause approximately 24,000 deaths of women in the United States annually (Ensor & Cooper, 2004). Further, the national prevention strategy aims are reducing the transmission of HIV through improved testing and the use of antiretroviral therapy, which reduces the 92% likelihood of transmission of HIV to other individuals (Centers for Disease Control and Prevention, 2011).

STDs can lead to serious long-term consequences if not treated, especially for girls and women as it can lead to infertility, cancer and transmission of HIV. Reproductive health services are the entry point to the medical care systems. These services improve health through cost reduction of medical services, provision of HIV and STD testing and treatment (Moore et al., 2013). The national prevention strategy runs programs for screening intimate partners for violence, reproductive cancer and provision of counseling on nutrition as well as physical activity.  For example, the annual, publicly funded family planning services helps in the prevention of almost 1.94 million unwanted pregnancies, hence reducing approximately 400,000 teenage pregnancies.  This consequently reduces $4 dollars spent on Medicaid expenditures hence reducing the costs of pregnancy related care (Kirchengast, 2012).

Conclusion

The reproductive health programs seek to strength the capacity of the health workers to address cultural sensitive issues in the society. This is because the reproductive health needs are sensitive to age; therefore, the preventive strategy seeks to improve the training of the healthcare workers in the reproductive health and human sexuality.  In this way, they will be in a better position of providing support and guidance to individual parents, adolescents and the elderly with different needs.  The preventive program seeks to monitor and evaluate on a regular basis the progress, quality and effectiveness of the reproductive health programs. Reproductive and sexual health is the critical component in the determination of overall health overall quality of life for both genders. The improvement of reproductive and health services can lead to the prevention of unintended pregnancies, because close to half of all the pregnancies are unintended. The reproductive and sexual health also prevents adolescent pregnancies, which accounts for over 400,000 teen girls pregnancies. To increase service delivery and improve reproductive and sexual health, it is critical to increase the use of preconception and prenatal care. It is essential to support reproductive and sexual health services and support services for pregnant parenting women. Through is achievable through provision of effective sexual health education for the adolescents and women.

 

References

Frost, C. J., Murphy, P. A., Shaw, J. M., Jones, K. P., & Varner, M. (2013). Reframing the View of Women’s Health in the United States: Ideas from a Multidisciplinary National Center of Excellence in Women’s Health Demonstration Project. Clinics Mother Child Health11, 156.  Retrieved from http://www.omicsonline.com/open-access/reframing-the-view-of-womens-health-in-the-united-states-ideas-from-a-multidisciplinary-national-center-of-excellence-in-womens-health-demonstration-project-2090-7214-1000156.pdf?aid=22707?aid=22707

Ensor, T., & Cooper, S. (2004). Overcoming barriers to health service access: influencing the demand side. Health policy and planning19(2), 69-79. Available at

http://heapol.oxfordjournals.org/content/19/2/69.full.pdf+html

Brownson, R. C., Baker, E. A., Leet, T. L., Gillespie, K. N., & True, W. R. (2010). Evidence-based public health. Oxford University Press. Available at

http://books.google.co.ke/books?hl=en&lr=&id=9fxzvhVoD2cC&oi=fnd&pg=PR17&dq=Considerations+for+National+Public+Health++Leadership+in+Advancing+Sexual+Health&ots=kOIduzseZs&sig=E5noVZ1XT6WQSqN6ZswLnh3z1rU&redir_esc=y#v=onepage&q&f=false

Ivankovich, M.B., Fenton, K.A., Douglas, J.M. (2013). Considerations for National Public Health: Leadership in Advancing Sexual Health. Public Health Reports, Supplement 1,Volume 128. http://www.publichealthreports.org/issueopen.cfm?articleID=2945.

Centers for Disease Control and Prevention (CDC. (2011). Vital signs: teen pregnancy–United States, 1991–2009. MMWR. Morbidity and mortality weekly report60(13), 414. Available at http://scholar.google.com/scholar?as_ylo=2010&q=prevention+of+teenage+pregnancies&hl=en&as_sdt=0,5

Kirchengast, S. (2012). Teenage-pregnancies from a Human Life History Viewpoint–an Updated Review with Special Respect to Prevention Strategies. Current Women’s Health Reviews8(3), 248-255. Available at

http://www.ingentaconnect.com/content/ben/cwhr/2012/00000008/00000003/art00006

Moore, N., McGlinchey, A., & Carr, A. (2013). 14 Prevention of teenage pregnancy, STDs and PHV infection. Prevention: What Works with Children and Adolescents, 287. Retrieved from

http://books.google.co.ke/books?hl=en&lr=&id=l_kspl4T02kC&oi=fnd&pg=PA287&dq=prevention+of+teenage+pregnancies&ots=btlNoC8FFu&sig=hVLcXcmFxnNM7Gug41BU5zMY6fw&redir_esc=y#v=onepage&q=prevention%20of%20teenage%20pregnancies&f=false

Hoggart, L., & Phillips, J. (2011). Teenage pregnancies that end in abortion: what can they tell us about contraceptive risk-taking?. Journal of Family Planning and Reproductive Health Care37(2), 97-102. Retrieved from

http://jfprhc.bmj.com/content/37/2/97.short

 

 

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