Reproductive health: a global overview.
WHO defines reproductive health as people having the ability to reproduce, to regulate fertility, and to practice and enjoy sexual relationships. It also means safe pregnancy, child birth, contraceptives, and sex. Procreation should include a successful outcome as indicated by infant and child survival, growth, and healthy development. 60-80 million infertile couples live in the world. Core infertility, i.e., unpreventable and untreatable infertility, ranges from 3% to 5%. Sexually transmitted diseases, aseptic abortion, or puerperal infection are common causes of acquired infertility. Sub-Saharan Africa has the highest prevalence of acquired infertility. In 1983, the world contraceptive use rate stood at 51% with the developed countries having the highest rate (70%) and Africa the lowest rate (14%). About 40 countries in Africa and the Arabian Peninsula practice female circumcision. The percent of low birth weight infants is greater in developing countries than in developed countries (17% vs. 6.8%). Intrauterine growth retardation is responsible for most low birth weight infants in developing countries while in developed countries it is premature birth. About 15 million infants and children die each year. Maternal mortality risk is highest in developing countries especially those in Africa (1:21) and lowest in developed countries (1:9850). Sexually transmitted diseases continue to be a major problem in the world especially in developing countries. Chlamydia afflicts 50 million people each year. The proportion of women with AIDS is growing so that between the 1980s and 1990s it will grow between 25% and 50%. More available contraceptive choices enhance safety in fertility regulation. Socioeconomic conditions that determine reproductive health are poverty, literacy, and women's status. Sexual behavior, reproductive behavior, breast feeding, and smoking are life style determinants of reproductive health. Availability, utilization, and efficiency of health care services and level of medical knowledge also determine women's reproductive health.