Women's reproductive health--challenges for the 1990s

Health policy makers, program planners and donor agencies have paid little attention to issues surrounding women's reproductive health. This paper will look at reproductive health issues surrounding pregnancy and childbirth, the accessibility and safety of contraception, and reproductive tract infections. The gross social injustice caused by high maternal mortality can no longer be ignored. Nor can we ignore the much larger numbers of women who suffer life-long health impairment resulting directly from the health hazards associated with pregnancy and childbirth. The challenge is to reduce maternal mortality by at least 50% by the year 2000. If these challenges are not faced, the 1990s may very well be remembered as the decade that saw the largest numbers of women dying in childbirth and pregnancy. The 1990s will see the addition of some 300 million couples to the reproductive age group. These couples will need access to good sexual health care, including safe and effective contraception, and prevention of reproductive tract infections and sexually transmitted disease. The biomedical consequences of reproductive tract infections are, among others, fetal wastage, low birth weight, carcinoma of the cervix, infertility and ectopic pregnancy. In addition to these consequences, there are the psychological, social and economic costs of these diseases. Some suggestions for meeting these challenges are put forward. These include building on existing programs and expanding available resources to help women to attain health, dignity, and their basic human rights.