International Conference on Reproductive Health December 01-02, 2016 San Antonio, Texas, USA

Biography:

Hyunsan Cho has completed his PhD in Sociology at University of North Carolina, Chapel Hill and currently, he is a Research Scientist at Pacific Institute for Research and Evaluation (PIRE) in Chapel Hill, NC. His primary research interests are centered on “Adolescent behavioral problems, HIV prevention research in Sub-Saharan Africa, research methods, and quantitative approaches”. Currently, he is a Principal Investigator of two grants titled “school support as structural HIV prevention for adolescent orphans in Kenya (R01)” and “pathways to HIV risk among orphan school dropouts in Kenya (R21)” funded by National Institute of Mental Health (NIMH).

Abstract:

Orphans, compared to non-orphans, face a higher risk for unwanted pregnancies and sexually transmitted infections, including HIV. However, there is a paucity of research on orphans’ reproductive behaviors such as family planning practices. For this study, we used a mixed methods approach and data from two studies funded by National Institute of Health (NIH) to examine sexual and reproductive behaviors and outcomes among orphan adolescents in Kenya. Quantitative data were obtained from the project “school support as a structural intervention among orphan adolescents in Kenya” (n=835) and qualitative data from the study “pathways to HIV risk among school dropouts in Kenya” (N=82). Respondents were orphan adolescents aged 11-23 in 2011-2014. By 2014, about 50% of participants had ever experienced sexual intercourse, 18% were ever married, 19% of females were ever pregnant, and 76% of males were circumcised. Among females, those who had a pregnancy ending in miscarriage, abortion, or stillbirth increased from 4% to 14% from 2011 to 2014. Among sexually active participants, condom use at first intercourse increased from 32% to 63% over time, but females were less likely to report condom use than males. From the interviews, we found that many reported that condoms were easily available and that participants mostly used condoms to prevent HIV. Many also reported discontinuing condom use with regular sex partners when they were aware of their negative HIV status. Further, participants reported disagreements with sex partners as a reason for not using condoms. Few participants used any modern contraceptives for family planning purposes. More research is needed to better understand orphans’ unique reproductive behaviors to inform the development of effective family planning interventions for this vulnerable population.

Biography:

Reem A Ali has got her graduate degrees from Universities in Canada. Besides earning her academic degrees in Nursing, she had an international exposure to research studies and willing to continue collaboration with researchers from outside Jordan. She is an Assistant Professor at Maternal and Child Health department at Jordan University of Science and Technology for about six years. She has conducted a study examining the relationships between maternal attachment and infant sleep problems in preterm infants following discharge from hospital. Her work is fundamental to understand more about relationships between attachment, maternal settling behavior, and infant sleep. Also, she is conducting research studies on Health Promotion for newborn, children and their families, focusing on children’s eating behaviors and reproductive health for youth.

Abstract:

Introduction: Health promotion is the most cost-effective method to reduce and prevent health problems. Using interactive teaching approach showed positive results in changing lifestyles and adopting more healthy practices among students. Little information was found on students’ knowledge and attitudes of reproductive health in Jordan.

Aim: To examine the effectiveness of an interactive teaching approach in promoting health awareness of reproductive health in undergraduate non-medical students in Jordan.

Methodology: A quasi-experimental one group pretest and post-test design was employed to examine the change in university students’ knowledge and attitudes toward reproductive health. A purposive sample of 210 students aged 18-24 years was used for this study. Knowledge and attitudes regarding reproductive health issues were assessed using a computer-based questionnaire developed by the researchers. Ethical approval was obtained from JUST Board of Ethics. The data was analyzed using Statistical Package for the Social Science (SPSS) version 19. Descriptive and parametric analyses were conducted to analyze the data.

Results: A significant improvement in students’ level of knowledge and attitudes toward reproductive health was indicated by the analysis. The results of a mixed between-within subjects analysis of variance showed a significant interaction between gender and students’ knowledge (pretest and posttest), Wilks Lambda=0.98, F (1.208)=4.09, p=0.04, partial eta squared=0.19. While there was no significant interaction between gender and students’ attitudes toward reproductive health on pretest and posttest, Wilks Lambda=0.99, F (1.208) = 2.03, p=0.16, partial eta squared=0.01.

Conclusion: The implementation of health promotion courses tapping on reproductive health issues while using interactive style targeting university students is an influential method for students at this age to improve their knowledge and attitudes regarding reproductive health which ultimately will improve their quality of life and health outcomes.

Biography:

Shamim Chandani is Senior Instructor at Aga Khan University, School of Nursing and Midwifery, Pakistan. She has published many research articles on Reproductive Health. She has presented her research in various international conferences.

Abstract:

Introduction: Peri-conception period is defined as the period extending from three months before (preconception) to three months after conception. This phase gives opportunity to couple to prepare themselves for parenting role plan for child growth and development.

Aim: The objective of this paper is to propose strategies educating couples to manage challenges associated with early childhood development (ECD) issues neonatal morbidity and mortality.

Method: Literature was reviewed on current research articles on peri-conception teaching and its impact on parenting role. Electronic data base (PubMed, Elsevier and Google scholar) were searched. There were 1287 research articles found, 208 were selected on peri conception teaching to couple. Most of the literature found was from developed countries, however very few articles were written in context of developing countries.

Recommendations: Arrange classes for future couples, involvement of community leaders, seeking assistance of religious leaders/mosque imam, adding chapter on role of parenting in higher secondary curriculum, midwifery and nursing curriculum focus more on peri-conception classes and programs on fetus growth and parental worries in media may be few strategies to have healthier generation by minimizing early childhood deficiencies and from non-communicable diseases in future.

Conclusion: Educating/awareness of couple for parenting role and its anticipation can diminish child bearing stressors and can lead to healthier family. Educating the couple before conceive will help to decide for pregnancy and time to get ready for new role. The above mentioned strategies may help to reduce the rate of neonatal deaths of below five years and national financial burden on individual as well as on nation and this money can be utilized on education, insurance etc.

Biography:

Tshering Yangden has completed her two years Certificate Course in Nursing from Royal Institute of Health and Science Ministry of Health, Thimphu, Bhutan. She is working as Nurse under JDWNRH Hospital. She has carried out various functions under various departments like Medical, Surgical, Orthopedic, Maternal Child Health etc. She worked as a Nurse in Basic Health unit of Dechen Choling related to mother child health (MCH), family planning and nursing care.

Abstract:

Demography: Bhutan’s population was 672,425 in 2005 with women of reproductive age group (15-49 years) about 160000 with about 12500 live births per year (PHCB 2005). TFR has dropped from 5.6 in 1994 to 2.3 in 2012 (NHS 2012).

Major RMNH Components: Safe motherhood includes EmONC, P&M of complicated abortions and family planning P&M of infertility. Reproductive tract infections include HIV, screening and prevention of cervical and breast cancer, newborn care, adolescents’ health-teenage pregnancy reporting mechanism.

Issues/Challenges/Concerns: Disparity in the algorithm of maternal and child care–ANC, delivery, PNC, immunization, IMR and U-MR is two to three times higher in the poor quintile compared to the richest. Maternal deaths occur mostly in far flung areas. Home deliveries still take place predominantly in the rural settings. Recording and investigating deaths following home delivery remains a major challenge (under reporting, unrecorded). Emphasis/compliance of birth plans preparation by pregnant women still remains weak (draft institutional delivery study, 2016). Tracking of pregnant women and especially high-risk pregnancies is a challenge. PNC coverage and access in rural settings remain relatively lower as compared to other settings. Pap smear coverage is low for want of female health workers–environment, advocacy, among other reasons. Increasing number of CS is not need-based. Growing number of women seeks abortions in neighboring India. Use of family planning methods is concentrated on a few methods (supplies).

Way Forward: Web-based MCH tracking system would be major breakthrough to address spectra of maternal and child care–computers, internet connectivity, and nothing short of commitment by users! Healthcare providers should ensure every woman has a comprehensive birth plan in the health center. Training of healthcare providers on PPH–guideline being revised focusing on prevention and management. Training Packages are on KMC, neonatal resuscitation and ENAP! Underscoring our priorities, challenges and opportunities, let us work hard, invest our energy, time and resources channeling through right course, right direction towards right goals! But working together in the spirit of relentless coordination, consultation and collaboration on the international platform would be great help to the under developing countries like Bhutan.

Biography:

Winifred Wafula  has completed her graduation as Medical Doctor from Makerere University, Kampala, Uganda in 1995. She also completed her Master of Science degree in Pharmacology from the same University in 2000 and then started working at Centers for Disease Control and Prevention, CDC, Entebbe, Uganda. Currently, she is the Head of Department, Pharmacology and Therapeutics at Busitema University.

Abstract:

Background: Menstrual history can reveal important pointers to conditions in a woman’s life, ranging from a normal pregnancy to malignant disease. Failure to take menstrual history for a woman seeking health care is a serious omission as the quality of care that follows is suspect. As part of our study on drug use patterns in Uganda with emphasis on prescription of medications that are potentially harmful in pregnancy, we set out to assess if and how often prescribers consider the possibility of pregnancy while treating women of reproductive age in the general outpatient clinics (OPDs).

Methods: A prospective survey among women aged 14-45 years attending OPDs in two districts in Uganda in August 2016. Ethical approval was obtained from Mbale Regional Referral Hospital Research and Ethics Committee as mandated by the Uganda National Council for Science and Technology. Written informed consent was obtained from all the participants.

Results: 94 exit interviews were conducted in eight health facilities. Only 24 (25.5%) of the respondents had their menstrual history taken. 48 of the women who did not have their menstrual history were from Mbale hospital OPD where only 10 (17.2%) had their menstrual history. Medications were prescribed to 64 (91.4%) of the women who did not have their menstrual history taken; 44 (69%) had at least one antibiotic.

Conclusion: A review of the training and supervision of the prescribers in Uganda may be required.

Biography:

Harpreet Vander has completed her MSc (Hons) in Microbiology in Department of Microbiology at Panjab University, Chandigarh, India and currently pursuing her Doctoral degree in the same. She has published seven papers in reputed journals. Her abstract entitled “Uropathogenic microorganisms and female infertility: An in vivo study” has been ranked among the first 100 best works in 17^th World Congress on Gynecological Endocrinology held in March 2016 at Florence, Italy.

Abstract:

Infertility in females as a consequence of asymptomatic microbial colonization of genital tract is under-acknowledged. A number of microorganisms have been known to elicit multiple deteriorative effects on sperm parameters in vitro, but their impact on fertility under in vivo conditions is still being argued. Earlier in our laboratory, infertility as a result of vaginal colonization with sperm impairing micro-organisms viz. Staphylococcus aureus, Escherichia coli, Serratia marcescens and Candida albicans has been observed. Therefore, the present study was designed to evaluate the impact of other uropathogens viz. sperm immobilizing Pseudomonas aeruginosa and non spermagglutinating/immobilizing Proteus mirabilis and Enterococcus faecalis on fertility outcome. The doses of 10⁴, 10⁶, 10⁸ cfu of P. aeruginosa/P. mirabilis/E. faecalis was administered intra-vaginally into female Balb/c mice for 10 consecutive days followed by mating with proven breeder male on day 12. The results showed that female mice were rendered infertile in the group receiving P. aeruginosa. In contrast the group receiving non spermagglutinating/immobilizing strains showed abdominal distension, string of pearls and finally delivered pups at the end of gestation period. Further, no histopathological changes were observed in reproductive organs viz. ovary, uterus and vagina of mice in all the groups. Moreover, there were no significant changes in the malondialdehyde levels of vaginal tissue homogenates of all the groups as compared to control. In conclusion, female reproductive tract may be occasionally inhabited by uropathogens without producing any evident symptoms and this colonization with sperm impairing microbes can substantially contribute to adverse fertility outcomes.

Biography:

He was senior advisor, Data Management for Columbia U.  M and E and Logistics for USAID and Program Management, Evaluation and Logistics for the UN From 1990 and 2008. He has served in several countries in Africa, Asia, Pacific Island Countries and USA. Since 2009 he is a consultant on RBM Systems including evaluating large- scale programs and conducting Monitoring and Evaluation missions for Multi and Bilateral Agencies. In the same time presenting abstracts at International Conferences. His recent oral presentations were in Toronto, Canada, Lyon, France, Port of Spain, Trinidad and Tobago, Bangkok, Thailand. He is author of “Monitoring and Evaluation: Data Management Systems” and columnist for the CVE Newsmagazine, FL. 

Abstract:

Problem Statement:

Maternal and infant morbidity and mortality remain a global challenge and based on latest reports, mitigation efforts have not been encouraging. Unsustainable fertility rates continue to rise unabated in developing many countries. Inability to address these challenges has many implications.

Reasons for these dismal performances include limited access to quality services, qualified staff, poor logistics management and lack of commodities.

These poor outcomes prompted the author to develop the model: RH Analysis and Planning System (RAPSYS).

Methodology:

The participatory model is based on pilot-tested results. It is defined by key determinants – utilization, demand, access, supply and procurement; cross cutting components – coordination, supervision, funding, advocacy, capacity building M and E; and all driven by an enabling environment. The systems use expert experience to develop effective strategies including: qualitative assessment, Delphi ranking, action plan, commodity projection and monitoring framework.

Findings:

 There is adequate evidence that the conventional approach in program design and implementation continues to show different levels of understanding of the expected outcomes. This model has help vulnerable countries in streamlining their interventions, making them more result-based, efficient, effective, sustainable and accountable. It has been successfully implemented in ten Asian countries – Afghanistan, Iran, Bhutan, Sri-Lanka, Bangladesh etc.

Conclusion:

There is convincing evidence that the complications involved in designing development interventions have become more convoluted, unstructured, and poorly coordinated producing in many cases inadequate and dismal outcomes. The relevant tasks are daunting with resources becoming more and more limited. This framework is part of an initiative to help refine current processes and procedures. 

Biography:

Margaret N Keraka has her expertise in Research on Population and Reproductive Health and passion in improving the health and wellbeing of women. She has done various researches in Maternal and Child Health. She has organized conferences and workshops on “Integration of reproductive health programs”. She is currently developing training programs in Reproductive Health and Health Promotion.

Abstract:

Biography:

Prabin Khadka has completed his master at the age of 25 years from Tribhuwan University . He is the Senior Monitoring and Evaluation officer of Family Planning Association of Nepal (FPAN). FPAN is a non-profit organisation working in Sexual reproductive health and rights including Family planning reaching out with poor, marginalised and socially excluded people. As a M&E officer of FPAN's abortion program, He is responsible for monitoring , supervion, data  analysis and utilisation of data for program management of overall abortion program . His reesearches   had presented in different International conferences (orally and poster).

Abstract:

Background: Although Nepal's maternal mortality ratio has fallen over the past decade, unsafe abortion remains a leading cause of maternal morbidity and mortality. Safe abortion was legalized in Nepal in 2002, access to safe abortion remains a significant challenge.The government began providing comprehensive abortion care services in March 2004 . The Global Comprehensive Abortion Care Initiative (GCACI) Project attempts to scale up and improve access to quality SRH with a special focus on Safe Abortion Services (SAS) in ten rural districts of Nepal supporting the Family Planning Association of Nepal.

Objective : The study aims to assess the impact of GCACI programs in reducing the unsafe abortions in the remote areas of Nepal.  

Methodology:  In this study, information were collected and analysed from the 10 family health clinics of the Family planning association of Nepal situated in 10 disrics of Nepal. The identified data of 3 years (Jan 2013- Dec2015) service statistics were extracted from the Electronic Clinical Management information system (client based recording system).

Results: The service statistic data clearly indicates that there has been an increase in the number of clients mostly for safe abortion services (SAS). Over 21295 clients have accessed the Comprehensive Abortion Care (CAC) services during three year period (Jan 2013 -December, 2015). The proportionate ratio of surgical abortion was 46% whereas medical abortion was 54%. There were 498 were treated for incomplete Abortion. Post abortion contraceptive uptake has tremendously increased by 85%. And the long term permanent method has increased from  to 29 %^. The  Community based approaches, awareness programs and mobilisation of Female community voulunteers  under this project helped in  reaching out considerable numbers of underserved and marginalized people to access the safe abortion services and As a result project has contributed to reduce unsafe abortion incidences in ten districts of Nepal.

Conclusion : The FPAN clinics Under GCACI programs have provided quality abortion services to women in need in reducing the unsafe abortion. Findings also suggest that medical abortion is getting popular amd the numbers are increasing. The easily available of medical abortioin in the unauthorised/ unlisted sites leads in incomplete abortions..The grass root communtiy level female health volunteer workers has a significant role in helping  the women seeking abortion sevices. In addition innovative programs launched by the project such as awareness campaign, community groups engagement, Quality counselling with quality services and client management information system plays a significant role in reducing the unsafe abortions in Nepal

Biography:

Bisrat Fantaye Denberu has completed his MPH in 2015 from Jima University and Post-graduation in Pharmacoepidemology & Social Pharmacy from Addis Ababa University, School of Pharmacy. He is RH Logistics Senior Advisor in Ipas Ethiopia for the last nine years.

Abstract:

The data in Ethiopia showed that 42% of pregnancies were unintended and the annual abortion rate was 23 per 1,000 women aged 15-44 years in 2008. Unintended pregnancy and births have grave consequences to the mother and family and are global social and health burdens. In Ethiopia, hundreds die in health facilities each year from abortion-related complications, but many more suffer from injuries or illness related to unsafe procedures. Cognizant of these facts and with the intent to reduce maternal death due to unsafe abortion, the Ethiopian government revised the abortion law in 2005. However, adolescents and youths are at the fore front of the maternal mortality and morbidity due to unintended pregnancy in Ethiopia. Descriptive unmatched case-control study was conducted in selected health facilities in Addis Ababa. Cases were women of age 15-24 seeking an induced abortion service and controls were women of age 15-24 that seek ANC service in the clinics. A total of 330 women (110 cases and 220 controls) were studied. Chi-square test and logistic regression analysis were conducted to determine association using SPSS V 20 after entering data using Epi Info Version 7.1. The mean age of study participants was 22.45+1.77 and the mean age for sexual debut was 18.74. This study showed that married young women were at lower risk of seeking abortion service than single young women (never married, divorced, widowed) AOR 0.04 (95%CI 0.015-0.13) P<0.001. Use of at least one method of modern contraceptive found to be protective factor for young women from having an induced abortion. Young women not using any method have four times higher odds of seeking induced abortion than those using at least one method (AOR 4.3 CI 1.05-17.7 p=0.043). Unintended pregnancy is a determinant that predisposes young women for seeking an abortion service (AOR 33.1 CI 12.5-87.5 p<0.001). Young single women who are not using at least one method of contraceptives and those young women exposed to unwanted pregnancy are highly likely to resort to abortion regardless of their faith, belief and attitude towards abortion. When young, single women who are facing a burden of unintended pregnancy, they are highly likely to resort to induced abortion regardless of their faith, belief and attitude towards abortion. Sexual and reproductive health must be a vital component in the school system curriculum; that could help improve the cultural barriers in discussing reproductive health and abortion topics at family level.

Biography:

Dr. Bolan Yu is the associate professor and vice director of the Key Laboratory for Major Obstetric Diseases of Guangdong Province in the Third Affiliated Hospital of Guangzhou Medical University. She obtained B.S. degree in Biology from University of Science and Technology of China in 2000, M.S. degree in genetics from the Institute of Genetics and Developmental Biology of Chinese Academy of Sciences in 2003, and Ph.D. in Pharmacognosy from University of Illinois at Chicago in 2010. Her research focuses on interactions of environment and genetics on the male reproductive health. Her group first reported that genetic variation in NRF2 gene and related antioxidant signaling pathway was associated with human defective spermatogenesis, and found that smoking as a common risk factor in Chinese males could cause epigenetic instability in sperm DNA.

Abstract:

Smoking is one of the most common risk factor for reproductive health worldwide, and it has been proven to be associated with decreased fertility and poor semen quality. During human spermatogenesis, transition of histone to protamine and the remodeling of methylation of whole genome in mature sperm are two critical important epigenetic processes. However, whether cigarette smoke exposure could affect them are largely unknown. In our recent study, we demonstrated that both histone to protamine transition and methylation in sperm from heavy smoking men had significantly alterations compared to their nonsmoking counterparts in an ethnic Han Chinese population in South China. The abnormalities of sperm histone replacement in heavy smokers were found to be closely correlated with sperm motility, viability, concentration, counts, and cotinine levels. The ratios of protamine 1 to protamine 2 mRNA expression also significantly increased in heavy smokers and in TM3 cells treated with cigarette smoke condensate. In addition, heavy smokers had significantly increased global methylation in sperm DNA than nonsmokers. Further microarray data demonstrated that methylation status had significantly altered in many loci from sperm DNA of heavy smokers, including many imprinting genes and functional genes. These results are being validated in a large group of smoking population. Overall, our study demonstrated that smoking could lead to sperm DNA epigenetic instability by increasing the abnormalities of histone to protamine transition, causing alteration of protamine mRNA expression in mature sperm, and changing methylation profiling in human sperm DNA. These epigenetic alterations associated with smoking may potentially affect human fertilization, embryo development, and offspring growth.

Biography:

Dr. Ruchi Sharma (BAMS, MPH ) is currently pursuing her PhD at the age of 29 years from PGIMER, Chandigarh. She has published 3 papers in reputed journals, published books and has contributed several chapters in edited books. She has presented more than 30 papers in national and international conferences.

Abstract:

Introduction- In recent past, there has been a lot of discussion about disability and related issues among the medical fraternity. Still, the sexual and reproductive health (SRH) rights of the WWD have remained on the paper. Disabled women tend to postpone or ignore their SRH problems till these progress to unbearable severity because of stigma and discrimination (S&D) faced by them. This compromises their opportunity of unrestrained participation in various spheres of life.

Objectives

a) To ascertain the status of stigma and discrimination associated with SRH problems among WWD in a city of north India

b) To develop a model to reduce S & D associated with SRH of WWD

Methodology- 100 WWD with age 15 years and above with at least 40% disability were enlisted from various sources viz- Hospitals, Colleges, banks etc of Chandigarh city.  A self-administered questionnaire was used to gather information regarding socio-demographic details, medical history and self-reported symptoms suggestive of SRH morbidity. Stigma and discrimination pertaining to SRH problem was also explored. On basis of above findings a model was developed addressing attitudinal barrier (S&D) and other barriers faced by WWD in hospitals and society in general.

Results- Average age of respondents was 24 yrs. Many (42%) females had locomotor disability followed by blindness (32%), low vision (12%), hearing impairment (10%) and mental illness (4%).   Some (26%) respondents had abnormal medical history with hypertension followed by diabetes as commonly reported problem. In terms of SRH, 65 respondents had self-reported or diagnosed symptoms of Sexual and reproductive morbidity.

When interviewed regarding Stigma faced by them, majority (66%) of respondents said that their SRH problem were ascribed by people to disability-“2 baar abortion hua to sabhi ne kaha ki iss polio ki dikkat ki vjah se baccha kharab hua hai, sara din bethi jo rehti hai” (After 2 recurrent abortions everybody pointed that It was due to polio as I keep sitting most of the time)

Many (44%) WWD reported that people embarrassed them because of their SRH problem. Majority (75%) of WWD told that people’s reaction forced them to hide their problems. 80% respondents felt that their health problems made them feel that life was unfair to them. Furthermore, the negative attitudes health professionals and family member to disabled women's sexuality resulted in their own views of their sexual selves becoming negative. Some of them (16%) felt they were discriminated against by health professionals:2 abortion k baad yahan ayi to doctors ne kaha ki- “Tumhe baccha karne ki kya zarurat hai. Adopt nahin kar sakti thi..baccha kaise paida karegi. Koi tang karta hai kya bachhe k liye??”After two abortions when I came her for treatment I was questioned why I wanted to conceive and bear children. I should have opted for adoption as I am incapable of giving birth. Doctors even asked if I was forced for children by my family. Why would anybody force me?? I want my own children“Meri bed wetting ki problems ko doctors ne kabhi seriously liya hi nahin” My bed wetting problem was never taken seriously by doctors.

Based on above findings a model has been suggested to convert present hospital friendly to SRH needs of WWD. 2 ICMR sponsored seminars were also held to sensitize various stakeholders on SRH concerns of WWD.

Conclusion- Stigma and discrimination impede disabled women’s ability to access quality health services that respects the dignity of all users. Many disabled women have poor experiences in OBG OPDs with misinformed or insensitive health professionals.

Biography:

Mrs. Binita Karanjit Joshi has completed her Master Degree at the age of 43 years from Tribhuban University Nepal. She is Women Development Coordinator of Eurasia Reiyukai Nepal Office, UN affiliated organization. She has been working on women development in remote areas of Nepal on the field of women health issue and women empowerment since last  25 years. She has a lot of community based experience from different organization like Nepal Red Cross Society, Vulnerable Community Development Program, and Eurasia Reiyukai Nepal Office. Nepal is one of the least developing country in the world. Nepal is male dominated society and situation of women is backward than man. In this situation, it is challenges to work on remote field areas as golden opportunity for her life. For the create of  awareness generation,  she has frequentrly published on women  health and empowerment issues in daily newspaper. Blue Lotus is one of reputed award who has a lot of contributed in women development field.  She has also got a Blue Lotus award from Eurasia Reiyukai Nepal Office. 

Abstract:

Nepal is one of the least developing country in the world. Due to lack of education, Nepal's HIV prevalence has not changed much over the last five years. The estimated HIV prevalence age is among 15-49 years.  Apart from overall low HIV prevalence among adult population, the country's epidemic scenario looks much different among key populations where, in certain groups, HIV prevalence is much higher, notably among People who Inject Drugs, Men who have Sex with Men, Transgender People, Female Sex Workers and Male Labour Migrants and their families. Besides HIV prevalence among key populations, their size remains a considerable challenge for achieving as well as maintaining optimal coverage.

Stigme and discrimination :

One of the most difficult challenges for people living with HIV/AIDS (PLWHA) is to face nagative responses towards them by people in their social environment. As the above quotes show, attitudes towards PLWHA may be well informed and supportive or involve negative comments and actions. These responses may range from unconscious gestures, to rejection and mistreatment tinged with harassment and hostility. Nagative attitudes and behaviours related to HIV/AIDS that are based on unfouned ideas and fears constitute stigma and discrimination.

Stigma and discrimination often have a profound impact on the lives of people living with HIV/AIDS. Stigma and discrimination are one of the key barriers to combating the AIDS epidemic. They result in individuals denying they the HIV-positive, shying awat from preventive behaviors and being inhibited in seeking medical treatment out of fear that their health status will be discovered. Sufferers attemping to receive medical treatment may also experience a lack of commitment and mistreatment by health professionals. In addition, stigme and discrimination may cause infected people to lose social and economic support from their families. Fear of being identified as positive and discriminated against discourage individuals from seeking voluntary testing of their HIV status, thus affecting prevention and surveillance efforts.

In Nepal, stigma and discimination stem from beliefs that HIV/AIDS is a fatal, congagious disease readily transmitted in casual or indirect contact with a person with HIV/AIDS. in addition, the social and intimatenature of its transmission and the emphasis on its spread through sex work and drug use have created stereotypes of PLWHAs and the mistaken image that only immoral people are infected. In order to address inaccurate and damaging attitudes towards PLWHA, it is important to identify the nature of the cultural beliefs and practices that underlie them.

Biography:

Dinah b Opore has completed her Enrolled community health nursing from Kendu Adventist School of nursing,  Kenya registered community health nursing from Kenya medical training college and has completed BScN at the age of 34 years from Kenya Methodist University. She has co-ordinated reproductive health programs  especially cervical cancer screening servicesin the ministry of health in Manga Sub-county, Nyamira County for 3 years. She has done two research papers but has not published any. She has future plans to do masters in reproductive health and PHD in oncology. Currently she is working in Mbagathi hospital in Nairobi.

Abstract:

Over the past decade, the global health community has been giving increased attention to the importance of addressing cervical cancer prevention where the disease burden is greatest. In low-resource settings, visual inspection of the cervix is used to screen. As there is no access to pap-smear and liquid-based cytology is used as confirmatory tests. Kenya demographic survey, 2014 indicated that 96% of women of reproductive age have heard about cervical cancer but only 14% had been screened.  The government of Kenya health ministry on June 16^th 2016 announced that cancer is becoming a new threat to survival in Kenya .It is the second most common with 3,000 newly diagnosed and 1,600 deaths annually. Kenya Red Cross registry confirmed the new cases can reach 4200 annually. Fifteen new cases of cervical cancer are reported in Nairobi every weekly.

The vaccine used to prevent costs Sh7,000 in private sector. Kenya lacks proper financing for cancer programmes. The 2012-15 cancer control programme quietly expired last year with no funding realized. No specific vote was made for cancer control in the Health ministry’s Sh60 billion budget in the year 2015-2016 despite of the above alarming figures.

Negative beliefs and attitudes towards the concept of screening and prevention was identified, factors related to the service delivery system especially location of the services, minimal access to health care, location of the service delivery point, quality of care, physical aspects of the facility , lack of enough  trained health care workers and equipment contribute to low uptake of screening services.

The planning and delivering cervical cancer prevention services must have a clear understanding of the needs, concerns, and beliefs of women and communities to ensure that services will be accessible, acceptable, and utilized. A key step to achieving optimal coverage is to gain broad community support, communication strategies for raising awareness about services and encouraging participation, provision of  quality services in screening and treatment, consistent supply of equipment and supplies, adequately trained staff, facilities must be clean and welcoming .Provision of Cancer treatment centers in every Level 2,3,4 and 5 hospitals is important. Men empowerment can encourage screening. Procurement of cancer prevention vaccine in all Government hospitals and provision of the vaccine at affordable price and strengthening referral systems is important.

Biography:

Mother of two, living in a rural community in the lower North Island of New Zealand. Has a PGDip and Masters in Public Health and Is currently studying towards a PhD.  Employed as a senior lecturer in Anatomy and Physiology at the Universal College of Learning. Research outputs include a published article in the New Zealand Journal of Primary Health Care and was a guest speakers at this year’s World Primary Health Care Conference in Dubai.

Abstract:

Aim: The rate of sexually transmitted infections amongst midlife and older people in New Zealand, Britain, United States and Australia is rising. Popular culture increasingly celebrates a heightened sexuality for women in this population group. However, depictions of sexually savvy ‘cougars’ are at odds with reality for many women. International literature highlights that these women are often ill-equipped to negotiate safer sex and condom use, instead focusing on pleasing men and attributing their silence to spontaneity. This study aimed to explore the enablers and barriers to safer heterosexual sex as perceived by midlife and older New Zealand women.

Methods: This qualitative study, examine women’s perspectives of vulnerability and sexual risk taking behavior. Eight single women aged 40-69 participated in individual, in-depth interviews. Interpretative phenomenology was utilized and the analysis was supported by the theory of gender and power.

Findings: Analysis indicated that these women held misconceptions about STI transmission were not aware of sexual health promotion literature and had not discussed sexual health with their GPs. The women described valuing their own pleasure and their distaste for condom use, but data emphasized that women predominantly aligned their choices with men’s preferences. The data also highlighted that, from the women’s perspective, alcohol consumption was an important factor in safer sex decision making.

Conclusion: This study highlights that midlife women are both ill-informed and vulnerable with regards to sexual health.

Biography:

Dr Hifsa Altaf is a public health professional with over 14 years of experience providing expertise in family planning and reproductive, maternal and community health. Hifsa has international field experience, primarily in Asian countries, working with leading reproductive health & family planning organization “Marie Stopes Society (MSS) Pakistan”. As a General Manager she leads the quality component of the MSS Pakistan program along with supporting programs in London and other Asian countries. Dr Hifsa has been a speaker at numerous international health forums such as the Urban Health Conference in San Francisco, USA and has been acknowledged for her contributions by organizations such as the WHO and Pakistan Nursing Council.

Abstract:

Environemental and occupational risk factors adversly effect the health and performace of rural women. Research aims to identify  risk factors related to women reproductive health in age group of 15-40 years working  in Agricultural sector and interventions to  prevent hazradous effects. Sindh is province of  Pakistan with total land area  of 14.1 million hectares (mha). The cultivated area is 5.88 mha and net sown area is 2.39 mha. According to 1998 Census, population  of Sindh is 30.4 million and  51% live in rural area. “Hatri” is union council of Taluka Hyderabad (rural) of Sindh with population of 29,719. “Fazal Baghul” is a village of union council Hatri with population  of 1,019,  female population is 510.  Survey revelead that 40% of women work in agriculture filed, livestock, poultry, and cottage industry. The adverse impact of work related risks causing women reproductive health issues are exposure to hazardous chemicals used in agricuture  (pesticides, fertilizers, herbicides), accidents/ physical injuries caused by tools used during cultivation and mal-nutrition due to overwork and poverty. 

The study revealed that 50% of women suffer from reproductive tract infection, 30%  from Anemia and 16% have hormonal imbalance  and stress problems and 4% has breathing and other issues. Survey team with the community stakeholders provided  free  medical check-ups and treatment, diagnostic refral points for  laboratory investigation, iron suppliments,  protective masks for feild work and reproductive health awarness  to the clients. To cope with the issues  political commitement, government agility, community invovement and role of CSOs is seriously needed.

Biography:

Akang EN is an Anatomist with special interest on Fertility. He is currently pursuing his Post-doctoral training in the School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, South Africa. He teaches Anatomy including Embryology in Department of Anatomy at University of Lagos. He has over six years of experience in lecturing Anatomy in tertiary institutions and has been constantly involved in cutting edge research in fertility and has over 13 publications in this field. His research is focused on “Studies of the role of oxidative stress, DNA integrity and apoptosis in the pathophysiology of male reproductive system”.

Abstract:

Background: There is a passionate desire for couples to own their own biological children. Unfortunately, infertility index has been increasing with about 50% attributed to male factor infertility. Sperm DNA fragmentation has been suggested as one of the causes of infertility in men however, there has been a controversy as regards its relationship on the successful management of infertility.

Aim: This study is aimed at determining the impact of sperm DNA fragmentation on fertility potentials in a rat model.

Materials & Methods: 20 adult male SD rats were randomly divided into four groups of five rats each. Groups A₁ (distilled water) and B₁ (2 g/kg of 30% v/v ethanol) lasted for four weeks while groups A₂ (control; distilled water) and B₂ (2 g/kg of 30% v/v ethanol) lasted for eight weeks. At the end of each treatment, the animals were introduced to female SD rats on the pro-estrous day of their cycle. The testis was harvested and tested for oxidative stress while the cauda epididymis was harvested to test for epididymal sperm parameters and sperm DNA fragmentation.

Results: The sperm count, sperm motility and the number of fetuses sired by the animals that received alcohol decreased significantly. There was also a significant increase in malondialdehyde (MDA) and sperm DNA fragmentation and a concomitant decrease in testicular superoxide dismutase and reduced glutathione levels in animals that received alcohol compared to control.

Conclusion: Increased sperm DNA fragmentation alters the ability of spermatozoa to fertilize oocytes.