Tiêu đề SP-3_Ch-14_Reproductive Health.pdf ✅

Chapter Contents Aakash Educational Services Limited - Regd. Office : Aakash Tower, 8, Pusa Road, New Delhi-110005 Ph. 011-47623456 According to World Health Organisation (WHO), reproductive health means well being in physical, emotional, behavioural and social aspects of reproduction. Therefore, reproductively, a healthy society comprises people having physically and functionally normal reproductive organs and normal emotional and behavioural interactions among them in all sex- related aspects. REPRODUCTIVE HEALTH – PROBLEMS AND STRATEGIES Problems and strategies of reproductive health in human beings are explained as follows: (i) Over population : The main problem of India is its excessive population which is directly connected with reproductive health. To achieve total reproductive health, some plans and programmes were started. ‘Family planning’ programmes were initiated in 1951 in India and have been periodically assessed over the past decades. These programmes were popularly named Reproductive and Child Health Care (RCH) programmes. The major tasks carried out under these programmes are to provide facilities and support for building up a reproductively healthy society. (ii) Awareness about reproduction : Audio-visual and print media, governmental and non-governmental agencies are doing a good job to create awareness among people about reproduction in humans. Parents, close relatives, friends and teachers also have a major role in giving the above information. (iii) Sex Education : Sex education in schools should also be introduced and encouraged to provide right information about myths and misconceptions about sex-related aspects. (iv) Knowledge of growth of reproductive organs and STDs : Proper information about reproductive organs, adolescence (period of rapid growth between childhood and adulthood), safe and hygienic sexual practices, sexually transmitted diseases (STDs), e.g., AIDS etc., would help to lead a reproductively healthy life. Chapter 14 Reproductive Health Reproductive Health - Problems and Strategies Human Population Growth Methods of Birth Control Sexually Transmitted Diseases Infertility Assisted Reproductive Technologies (ART)
48 Reproductive Health NEET Aakash Educational Services Limited - Regd. Office : Aakash Tower, 8, Pusa Road, New Delhi-110005 Ph. 011-47623456 (v) Birth control devices and care of mother and child : Fertile couples and people of marriageable age group should know about available birth control devices, care of pregnant mothers, postnatal (after birth) care of the mother and child, importance of breast feeding, equal importance for the male and female child, etc. (vi) Prevention of sex abuse and sex related crimes : Awareness regarding problems due to uncontrolled population growth, social evils like sex abuse and sex-related crimes, etc. needs to be created so that people should think and take up necessary steps to prevent them and thereby build a reproductively healthy society. (vii) Information about reproduction related problems : The success of plans to attain reproductive health requires good infrastructural facilities, professional expert knowledge and material support. These are necessary to provide medical help and care for reproduction related problems like menstrual problems, infertility, pregnancy, delivery, contraception, abortions, sexually transmitted diseases (STDs). Implementation of better techniques and new strategies is also required to provide better care and help to people for reproductive health. (viii) Amniocentesis : Amniocentesis is a foetal sex and disorder determination test based on the chromosomal pattern of the embryo's cells in the amniotic fluid surrounding the developing embryo. UTERINE WALL PLACENTA AMNIOTIC FLUID FOETUS CELLS SHED BY GROWING FOETUS SYRINGE WITH NEEDLE TO WITHDRAW A SMALL AMOUNT OF FLUID AND CELLS Fig. : Amniocentesis Statutory ban on amniocentesis for sex-determination to legally check increasing menace of female foeticides, massive child immunisation, etc., are some programmes that merit mention in this connection. In Amniocentesis, some of the amniotic fluid of the developing foetus is taken to analyse the fetal cells and dissolved substances. This procedure is used to test for the presence of certain genetic disorders such as, Down's syndrome, haemophilia, sickle-cell anemia, etc., to determine the survivability of the foetus. Amniocentesis can be performed after 15 weeks of pregnancy typically between 16 to 20 weeks of gestation. (ix) Research in reproductive health area : It should be encouraged and supported to find out new methods. ‘‘Saheli’’ a new oral contraceptive for the females was developed by our scientists at Central Drug Research Institute (CDRI) in Lucknow, India. (x) Medical facilities : Better awareness about sex related problems, prenatal care of mother, medically assisted deliveries and post natal care of mother and infant have resulted in a decrease in maternal and infant mortality rates. Small families, better detection and cure of sexually transmitted diseases (STDs) and increased medical facilities for sex-related problems, etc. indicate improved reproductive health of male and female individuals and children. Measures to Control Over Population 1. Education : People, particularly those in the reproductive age group, should be educated about the advantage of a small family. Mass media and educational institutions can play an important role in this
NEET Reproductive Health 49 Aakash Educational Services Limited - Regd. Office : Aakash Tower, 8, Pusa Road, New Delhi-110005 Ph. 011-47623456 campaign. Posters showing a happy couple with two children with a slogan ‘‘Hum Do Humare Do’’ should be displayed. Many couples have even adopted ‘‘one child norm’’. 2. Marriageable Age : Raising of the age of marriage is a more effective means to control the population (now marriageable age of female is 18 years and that of a male is 21 years). 3. Incentives : Couples with small families should be given incentives. 4. Family planning : There are many birth control measures which can check birth rate. HUMAN POPULATION GROWTH Human population growth is measured as the annual average growth rate which is calculated as follows: Average annual growth rate (in percent) = 100 NP PP 1 12          where, P1 is population size in the previous census; P2 is population size in the present census; and N is number of years between two census. STAGES 1 2 34 POPULATION TIME TOTAL POPULATION DEATH RATE BIRTH RATE Fig. : Different stages of the demographic transition (1) High birth rate but fluctuating death rate, (2) Declining death rate and continuing high birth rate, (3) Declining birth rate and death rate, (4) Low death rate but fluctuating birth rate Census gives information about the number of individuals present in a given region at a given time. The time required for a population to double itself is called the doubling time. The world population was around 2 billion (2000 million) in 1900 rocketed to about 6 billion by 2000 and 7.2 billion in 2011. Our population which was approximately 350 million at the time of our independence reached closed to the billion mark by 2000 and crossed 1.2 billion in May 2011. According to the 2011 census report the population growth rate was less than 2 percent i.e., (20 individuals per 1000 of population) or 20/1000/year, a rate at which our population could increase rapidly. Population growth rate is indicated by (i) the annual average growth rate and (ii) the doubling time. Growth rate depends on birth (fertility) rate, death (mortality) rate, migration and age sex ratio. 1. Fertility (Natality) : Fertility is the ability of the reproductively active individuals to produce babies. Birth rate is the number of babies produced per thousand individuals. It differs from the population growth rate as it is never negative while the growth rate can be negative. Total fertility rate (TFR) is the average
50 Reproductive Health NEET Aakash Educational Services Limited - Regd. Office : Aakash Tower, 8, Pusa Road, New Delhi-110005 Ph. 011-47623456 number of children that can be borne by a woman during her lifetime. The total fertility rate varies from region to region. The more developed countries have lower fertility rates than the less developed countries. Fertility is mainly controlled by economics and human aspirations. Replacement level (RL) is the number of children a couple must produce to replace themselves so as to maintain the population at zero growth level. RL is slightly higher than 2.0 because some children die before reaching reproductive age. RL is 2.1 in developed countries and 2.7 in developing countries due to a higher death rate at immature age. 2. Mortality : Mortality is the death rate per thousand individuals. Death rate has fallen in most countries. It is due to improved personal hygiene, sanitation and modern medicines. Demographers generally use crude birth rate and crude death rate. Crude birth rate is the number of live births per thousand persons in the middle of a given year (i.e., on July 07). Crude death rate is the number of deaths per thousand persons in the middle of a given year (i.e., on July 07). The difference between the number of births and deaths is called the rate of natural increase. If birth and death rates were equal, a zero population growth rate would result which is known as demographic transition. It has occurred in most developed countries. Age and Sex Structures : The age structure of a given population refers to the proportion of individuals of different ages within that population. This aspect is important because many functional aspects of the individuals are related to age. For example, infants below one year of age and the older people have higher mortality rate than individuals of other ages. In addition, the proportion of reproductively active males and females in a population influences the population growth. The number of female individuals in active reproductive age (usually 15-44 years) influences the birth rate within a population. (a) Age Population (millions) Males 75 Females 70 60 50 40 30 20 10 0 320 280 240 200 160 120 80 40 0 0 40 80 120 160 200 240 280 320 Age Population (millions) (b) Females Males 75 70 60 50 40 30 20 10 0 320 280 240 200 160 120 80 40 0 0 40 80 120 160 200 240 280 320 Fig. : Age-sex pyramids between 1975 and 2000 : (a) Developed countries, (b) Developing countries Age-sex structure of a population can be depicted in the form of a pyramid diagram by plotting the percentage of population of each sex in each age. Figure shows the age-sex pyramid for the developed and developing countries for the years between 1975 and 2000. The age-sex structure of the developed world gives a steeper pyramid, which represents a nearly stable population. In contrast, a rapidly growing population, like that of India, is represented by a much less steep pyramid, as it has a much larger number of young people. The female side of the diagram is particularly important in understanding future growth.