REPRODUCTIVE HEALTH
ISSUES IN PAKISTAN
DR. ROSHAN ARA QAZI
Professor of Obstetrics & Gynaecolog
LUMHS,Jamshoro.
Reproductive Health
Learning Objectives
To know the definition and description
of Reproductive Health in general and
the key issues of reproductive and post
reproductive age in particular.
Reproductive Health
Definition

WHO has defined Reproductive Health as
“Reproductive Health (RH) is a state of
complete physical, mental and social well
being and not merely the absence of
disease or infirmity in all matters related to
the reproductive system and to its function
and process.”
Reproductive Health
Reproductive Health is for the male and
the female and covers the entire life
span.
It includes services for sexual health
reproduction and family planning.
Elements of
Reproductive Health
Information, education and counseling
on human sexuality and reproduction.
Elimination of discrimination against
girls and women.
Care during the entire maternity cycle
which includes prenatal, intranatal and
postnatal care, as well as emergency
obstetrics care.
Elements of
Reproductive Health
Access to quality services for the
management of complications from
unsafe abortion. In circumstances
where abortion is legalized, it should be
made safe. Post abortion family
planning counseling and service should
be made available.
Access to quality family planning
services including a full range of
contraceptives.
Elements of
Reproductive Health
Prevention and treatment of
reproductive tract infections, including
sexually transmitted diseases,
prevention of HIV/AIDS and availability
of affordable condoms.
Recognition and acceptance of the
enhanced role of men.
Management of menopause.
Elements of
Reproductive Health
Facilities to receive referral for infertility and
all morbid conditions related to reproduction,
such as cancers of the reproductive systems
and breast etc.
Appropriate sexual and Reproductive Health
information and culturally accepted services
to adolescents.
Elimination of harmful cultural practices like
very young age marriages and violence.
Statistics of Pakistan
Health and Demographic
Indicators
Total world population
Total Pakistan population
Population growth rate
Doubling time
Contraception
% knowing method
Contraceptive prevalence rate
Total fertility rate
6 billion
145.0 million
20.3%
30 years
97%
30%
5.0
Statistics of Pakistan
Health and Demographic
Indicators
Infant mortality rate
Maternal mortality rate
90/1000 live births
340/100,000 live births
Births
39 per 1000 pop
Deaths
11 per 1000 pop
Percent of population of age
<15
65+
Total
42
4
60
Rights and Principles
Reproductive rights include:
The right to care which should ensure
highest standards of sexual and
Reproductive Health.
 The right to freely decide the number and
spacing of children and to have the
information and resources to practice
family planning.

Life Cycle Approach to
Reproductive Health
RH is not merely confined to the health of the
individual at the age he/she is capable for
reproduction.
The life cycle approach recognized that each
stage of life, from infancy to old age has
reproductive needs.

The health of the infant is largely dependent on
the mother’s health status and access to
health care during pregnancy, childbirth and
immediate postpartum period.
Life Cycle Approach to
Reproductive Health
RH concerns increases during
adolescence and particularly for women
during the reproductive years.
 Earlier reproductive events will have a
bearing on the general health of an
individual when one gets old.

RH needs are therefore from “cradle
to grave” or “womb to tomb”
Reproductive Health:
Life Cycle Approach
Stages in life
cycle
Perinatal
(28 wks of
Gestation –7
days after birth
Health Issues
Promotion, prevention,
Treatment, Rehabilitation
Fetal death
Prenatal care.
Intra-uterine retardation Nutrition.
(low Birth weight &
Immunization with tetanus
prematurity)
Toxoid.
Immunizable diseases.
Reproductive Health:
Life Cycle Approach
Stages in life
cycle
Infancy
(Birth – 1
year)
Health Issues
Promotion, prevention, Treatment,
Rehabilitation
abnormal
Care of mother & newborn (mother baby
growth and
care package)
development
Breast feeding
Malnutrition.
Immunization(EPI)
Communicable Growth monitoring (mile stones)
disease.
Nutrition, education & counseling.
Accidents.
Oral rehydration therapy (ORT)
Child abuse.
Chronic diarrheal diseases. (CDD)
Control of upper respiratory tract
infection.
Education and counseling on prevention
Reproductive Health:
Life Cycle Approach
Stages in life
cycle
Child hood
(1 – 10 years)
Health Issues
Infectious
diseases.
Malnutrition.
Accidents and
injury
Child abuse.
Promotion, prevention, Treatment,
Rehabilitation
Immunization (EPI)
Oral rehydration therapy (ORT)
Chronic diarrheal diseases. (CDD)
Acute respiratory tract infection (ARI)
control.
Growth monitoring.
Nutrition supplementation.
Parent’s counseling on normal growth &
development of a child.
Prevention against accidents and
abuse.
Reproductive Health:
Life Cycle Approach
Stages in life
cycle
Adolescence
(11 – 21)
Health Issues
Unhealthy lifestyle
Early marriage
Unwanted pregnancy
Complication of teen
age pregnancy
Morbidity and mortality
due to early pregnancy
RTIs / STDs
Promotion, prevention,
Treatment, Rehabilitation
Education on health lifestyles.
Nutrition and fertility awareness.
FP information and service.
Counseling on sexuality.
Treatment of RTIs and referral.
Reproductive Health:
Life Cycle Approach
Stages in life
cycle
Adulthood /
reproductive
years
22 – 45
years
Health Issues
Unhealthy life style.
Nutritional problems
Menstrual
abnormalities.
Genital tract cancers.
Breast lumps.
Genital tract benign
tumors.
Excessive vaginal
discharge.
Premarital general
health.
Anemia.
Promotion, prevention, Treatment,
Rehabilitation
Education on healthy life style.
Balanced diet. Calcium & Iron
Early detection, counseling and
treatment.
Screening, diagnosis & treatment.
Screening and counseling.
Early diagnosis and treatment.
Counseling, reassurance &
treatment of pathological discharge
Counseling and screening.
Early detection and treatment.
Reproductive Health:
Life Cycle Approach
Stages in life
cycle
Adulthood /
reproductive
years
22 – 45
years
Health Issues
Promotion, prevention,
Treatment, Rehabilitation
Pregnancy and related problems Maternal care
Maternal mortality
Nutrition
& morbidity.
FP information and service.
Complications of
Infertility diagnosis / referral
abortions.
Counseling on human
sexuality.
Fertility regulation
Violence against women &
Infertility
Violence against Men
Sexual abuse / harassment.
RTIs, HIV/AIDS diagnosis &
Harmful traditional
management / referral
practices
RTIs /STDs /
HIV/AIDS
Reproductive Health:
Life Cycle Approach
Stages in life
cycle
Post
Reproductive
Years
Female
Health Issues
Promotion, prevention,
Treatment, Rehabilitation
Sexual dysfunction.
Counseling / assurance
Menopausal problems.
Nutrition
Osteoporosis.
Supportive care
Cancers of
Early diagnosis and treatment of
reproductive tracts.
cancers
Inability to cope.
Depression
Reproductive Health:
Life Cycle Approach
Stages in
life cycle
Male
Health Issues
Male Sexual dysfunction.
Occupation related RH
illness.
Inability to cope.
Depression
Promotion, prevention,
Treatment, Rehabilitation
Counseling / assurance
Nutrition
Supportive care
Early diagnosis and treatment
of cancers
Key Measures for the
Community
Reproductive Health of both male and female
is important.
In a life cycle approach, one must take care
of a fetus, neonate, infant, child, adolescence
and finally the adult in both reproductive and
post reproductive years.
Every problem in the life cycle must be clearly
taken care by each and every concerned
member of the society to full fill the needs of a
healthy community.