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Global Health > Global Health Classes 4-6 (Maternal/Reproductive Health) > Flashcards

Global Health Classes 4-6 (Maternal/Reproductive Health) Flashcards

1
Q

Spacing

A

the time you wait between pregnancies

2 years is considered the minimum amount of time you should wait between births. 3 years is recommended

mom, 1st baby and 2nd baby are all at higher risk of death if births happen faster

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2
Q

Most dangerous ages for pregnancy

A

Pregnancy over 35 and under 18 are the most dangerous times

Body isn’t developed enough yet before 18. Body is starting to break down by 40

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3
Q

Birth Monitoring

A

Risk of death is significantly higher without a trained birth attendant

Trained birth attendant provides higher level of security than untrained birth attendant

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4
Q

PID

A

pelvic inflammatory disease

a general term for infection of the uterus lining, fallopian tubes, or ovaries.

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5
Q

Pre-pregnancy consideration factors

A
  1. Age
  2. Health
  3. Spacing
  4. Monitoring
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6
Q

Birth attendant

A

Having a trained birth attendant available provides higher level of security than untrained birth attendant

Traditional birth attendants’ experience helps to make up for their lack of education

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7
Q

Issues with Referral Hospitals in Poor Countries

A

Transportation: Difficult to plan/execute in poor countries

Needs:

 - diagnostic equipment
 - blood
      - many poor hospitals don’t have blood banks
 - antibiotics
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8
Q

Problems during birth

A
  1. Preterm
  2. Pre-eclampsia/Eclampsia
  3. Breach
    • Baby isn’t being delivered head first
  4. Hemorrhage
  5. Fistula
    • Leak urine and feces
    • Needs surgery to repair
    • Caused by multiple births too close together or being
      too young (undeveloped)
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9
Q

Perinatal

A

The first week after birth. A subset of Neonatal period

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10
Q

Neonatal

A

The 28 days after birth. The Perinatal + the next 3 weeks

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11
Q

Infant

A

Under 1 year old

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12
Q

Child

A

Under 5 years old

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13
Q

Parity

A

Number of children born

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14
Q

What do neonates/infants/children die from?

A

The three major causes of neonatal deaths worldwide are:

  • infections (36%, which includes sepsis/pneumonia, tetanus and diarrhoea)
  • pre-term (28%)
  • birth asphyxia (23%).
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15
Q

Boy to Girl birth ratio

A

102-105 boys are born for every 100 girls

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16
Q

Crude Birth Rate

A

lives births per year per 1,0000 population

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17
Q

Crude Death Rate

A

deaths per year per 1,000 population

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18
Q

Perinatal Mortality Rate

A

Still-births + all deaths after birth within first 7 days per 1,000 population

(# of perinatal deaths / total # of births (still births + live births)) x 1000

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19
Q

Neonatal Mortality Rate

A

Deaths within the first 28 days after birth per 1,000 population
- The Perinatal + the next 3 weeks

only counts live births (not still-births)
Late neonatal: 8-27 days

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20
Q

Early neonatal

A

Deaths within 0-7 days. Doesn’t include still-births like Perinatal Mortality Rate

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21
Q

Natural Increase

A

= Crude birth rate - crude death rate

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22
Q

Infant Mortality Rate

A

(Deaths under 1 year/ Live births per year) x 1,000

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23
Q

Child Mortality Rate

A

(Deaths under 5 year/ Live births per year) x 1,000

24
Q

Maternal Mortality Rate

A

Death of mothers who are pregnant or gave birth within 42 days

 - Includes deaths related to abortion
 - Death has to be related to childbirth

Formula: (Maternal Mortality Rate/ Women of Reproductive Age) x 1,000

25
Q

Relative boundaries for high/low infant mortality rate

A

High infant mortality rate: 100 per 1,000

Low infant mortality rate: 10 per 1,000

Developing countries cross the threshold to developed countries when the rate is 65 per 1,000 and life expectancy at birth is > 65

26
Q

Hib

A

Haemophilus influenzae

 - Caused by bacteria
 - A vaccine has been developed

It is an ARI which converted to an EPI

This species was the first free-living organism to have its entire genome sequenced.

name started because hib was originally thought to cause influenza until the viral etiology of influenzea was discovered

27
Q

Fundamental component of reproductive health

A

giving women the power to control reproduction

28
Q

Contraception

A

preventing fertilization

29
Q

Contragestion

A

preventing implantation

30
Q

Barrier Methods

A

Condom
Female condom
Cervical sponge
Diaphragm (w/spermicide)

31
Q

Hormonal Methods

A 
the Pill
the Patch
the Ring
Mini-pill (POP)
     - Can breastfeed using mini-pill
     - Only uses progesterone

Injectables

 - Depo Provera (3 months)
 - Noristerat (8 weeks)
 - Implants
32
Q

IUDs

A

Plain (Original Lippes Loop)

Copper-T

Progestogen (progestin) releasing

33
Q

Sterilization: Surgical

A
  • Vasectomy (male)

- Tubectomy (female)

34
Q

Sterilization: Nonsurgical

A

Quinacrine: sclerozing agent
Essure: spring in the fallopian tube

35
Q

Essure

A

Three months after insertion a physician performs an x-ray test called a hysterosalpingogram, also known as an Essure Confirmation Test to confirm that the fallopian tubes are completely blocked and that the patient can rely on the Essure inserts for birth control.

36
Q

Number of FGM victims worldwide

A

Worldwide: Estimated 100 to 140 million girls and women living with consequences of FGM

Performed usually on young girls between infancy and age 15

Internationally recognized as a violation of the human rights of girls and women

37
Q

Where is FGM most common

A

Most common in the western, eastern, and north-eastern regions of Africa

Some countries in Asia and the Middle East

Certain immigrant communities in North America and Europe

38
Q

FGM rationale

A

FGM is a social convention

 - Right of passage into adult womanhood
 - Strong social pressure to conform
 - Not eligible for marriage without it

Beliefs about proper sexual behavior, linking procedures to premarital virginity and marital fidelity

 - Reduce a woman’s libido
 - help her resist “illicit” sexual activity

Cultural ideas of femininity and modesty,
- Notion that girls are “clean” and “beautiful” after removal of parts that are “unclean”

Often believed practice has a religious basis – no scriptural basis

39
Q

Type I: Sunna

A

Partial or total removal of the clitoris and/or the prepuce (clitoridectomy)

40
Q

Type II: Excision

A

Partial or total removal of the clitoris and the labia minora, with or without excision of the labia majora (excision)

41
Q

Type III: Infibulation

A

Narrowing of the vaginal orifice with creation of a covering seal by cutting and appositioning the labia minora and/or the labia majora, with or without excision of the clitoris (infibulation)

Infibulated women have to be re-opened (deinfibualted) on delivery of their child
- No reliable data, but it is likely that the risk of maternal death and still-birth is greatly increased

42
Q

FGM Short-Term Consequences

A

Shock

Hemorrhaging

Ulceration of genital region

Fractures or dislocation (when a struggling girl is restrained)

Bacterial infections - tetanus and general septicemia

43
Q

FGM Long-Term Complications

A

Fistula a common outcome

Recurrent urinary tract infections

Incontinence (can’t control bladder)

Obstetric: scars in clitoral zone open during childbirth and cause anterior perineum to tear and hemorrhage

44
Q

FGM Psychosexual Consequences

A

Severe types of infibulations often result in sexual dysfunction and reduced sexual sensitivity

Behavioral disturbances in children

Women may suffer feelings of incompleteness, anxiety, depression

Some traumatized women suffer in silence

45
Q

Maputo Protocol

A

Adopted by African Union, July 2003

 - Comprehensive rights to women
 - Equality with men
 - Control of their reproductive health  
 - End female genital mutilation
46
Q

Demographic Transition

A

As countries develop, the death rate always decreases before the birth rate. This leads to a population explosion which causes economic issues for the country.

US went through demographic transition over 150 years

Developing countries today are going through it in 30-50 years which is not enough time to develop jobs, infrastructure, education or support for the population explosion.

47
Q

Quinacrine

A

sclerozing agent- creates a scar

if quinacrine is applied to the fallopian tubes, it creates scarring which creates sterilization

Super cheap (pennies) and doesn’t require a doctor to administer

FDA won’t allow use or clinical trials

quinacrine taken orally is used to treat malaria

48
Q

Behavioral contraceptive methods

A

Calendar/Rhythm

Basal body temperature

Withdrawal

Abstinence

Lactation - LAM

49
Q

LAM

A

lactational amenorrhea method
- women can’t get pregnant while breast feeding

optimum breastfeeding timeframe is 2 years. minimum spacing between births is 2 years

50
Q

Emergency Contraception

A

IUDs
- can be lightly jiggled to causes menstration

Plan B
- fuzzy whether it qualifies as abortion pill or contraceptive

RU-486
- abortion pill

51
Q

Spontaneous abortion

A

commonly occurs when the fetus is deformed and would not be able to survive

52
Q

Replacement fertility

A

refers to having just enough babies to maintain the current population
- need about 2.1 kids in a developed country to have replacement fertility

  • need about 2.3 - 3.0 in developing countries
53
Q

Age-specific fertility

A

the number of kids women have each year during their reproductive years
- ages 15-45

54
Q

Years for population to double

A

69 / Population Growth %

55
Q

Demographic transition:

A

transition from very high to lower or very low birth rates

Global Health (3 decks)

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