Dissertations / Theses on the topic 'Reproductive policy'
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Batty, Lynne Patricia. "Assisted Reproductive Technology: The Aotearoa/New Zealand Policy Context: A thesis submitted in fulfilment of the requirements for the degree of Master of Arts in Sociology in the University of Canterbury." Thesis, University of Canterbury. Sociology, 2002. http://hdl.handle.net/10092/912.
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The focus of this thesis is the current policy situation in relation to assisted reproductive technologies (ART) in Aotearoa/New Zealand. I explore how government policies (and lack of policy) have shaped access to ART. I also explore the policy initiatives of funding agencies, the National Ethics Committee on Assisted Human Reproduction (NECAHR), managers, healthcare professionals, and interest groups. My investigation into ART policy issues critically examines the various formal mechanisms and policies used to regulate and control ART in Aotearoa/New Zealand. Drawing on my analysis of policy-focused documents and material from in-depth interviews with key actors in the policy debate, I demonstrate how the ad hoc and contingent approach to ART developments, practices, funding, and access has contributed to inconsistent and inequitable access to ART services. I argue that the lack of an ART-specific policy organisation contributes to fragmented, and possibly discriminatory, policy decisions. I examine how the use of restrictive access criteria to manage the increasing demand for publicly funded ART services disadvantages certain groups wishing to use these services. By investigating the influence of rationing strategies on the allocation of resources and regulation of access, I provide some appreciation of the 'messy reality' of policy creation, interpretation, and implementation. I argue that the criteria used to limit access to public ART services obscure the use of social judgements and provider discretion. Likewise, they succeed in limiting publicly funded ART treatments to those who conform most effectively to the normative definition of family. My analysis of the ART policy discourse identifies silences and gaps in relation to specific ART practices, particularly the use of ART by Maori. I highlight the invisibility and marginalisation of Maori within the ART policy debate. After examining the broader issues concerning Maori access to health services, I explore how these may affect Maori using ART services to overcome infertility. I argue that the gathering of information about the utilisation of ART services is crucial for the accurate identification of the needs of Maori. It is also fundamental for effective monitoring of state health policy decisions and outcomes.
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Rokicki, Slawa. "Improving Reproductive Health: Assessing Determinants and Measuring Policy Impacts." Thesis, Harvard University, 2016. http://nrs.harvard.edu/urn-3:HUL.InstRepos:33493534.
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In this thesis, I investigate policies and programs to improve reproductive health. My thesis makes a substantive contribution to reproductive health policy and a methodological contribution to quasi-experimental research.
In chapter 1, I evaluate the impact of a mobile phone intervention for adolescent girls. I design and implement a randomized controlled trial in Ghana to test whether sending information via mobile phones is an effective way to improve girls’ knowledge of sexual health and to ultimately reduce teenage pregnancy. I find that mobile phone programs are effective not only in increasing knowledge, but also in decreasing risk of pregnancy among sexually active adolescents. I discuss the results in the context of sexual education policy in Ghana.
In chapter 2, I explore the complex interactions between migration and reproductive health. I reconstruct the complete migration and reproductive health histories of women residing in the urban slums of Accra, Ghana. Using individual fixed effects to reduce selection bias, I find an increased risk of pregnancy, miscarriage, and abortion in the 48 months after migration, with no significant increase in the chance of live birth during this time period. With half of abortions in Ghana classified as unsafe, these results suggest that policies which target the rapidly growing number of urban migrants by providing access to contraception and public hospital services may reduce unsafe abortion and improve maternal health outcomes.
In chapter 3, I investigate the bias of standard errors in difference-in-difference estimation, which typically evaluates the effect of a group-level intervention on individual data. Common modeling adjustments for grouped data, such as cluster-robust standard errors, are biased when the number of clusters is small. I run Monte Carlo simulations to investigate both the coverage and power of a wide variety of modeling solutions from the econometric and biostatistics fields, while varying the balance of cluster sizes, the degree of error correlation, and the proportion of treated clusters. I then apply my results to re-evaluate a recently published study on the effect of emergency contraception on adolescent sexual behavior. I find that the study’s results claiming that emergency contraception increases risky sexual behavior may be spurious once proper adjustments for grouped data are applied.Health Policy
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Moore, Donna L. "New reproductive and genetic technologies in Canada : towards a policy that manages technology and reproductive rights." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1997. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp01/MQ40188.pdf.
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Mayhew, Susannah Harding. "Health care in context : policy into practice : a policy analysis of integrating STD/HIV and MCH/FP services in Ghana." Thesis, London School of Hygiene and Tropical Medicine (University of London), 1999. http://researchonline.lshtm.ac.uk/682260/.
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This research is one contribution to understanding the nature of policy and of power. the interaction of the state and its machinery with individuals at all levels, the tensions between public and private choices and responsibilities, between public health and clinical health care. Adapting a policy analysis approach, this thesis provides a case study of the development and implementation of reproductive health policies in Ghana. The aim is to enhance understanding of why there are differences between policy and practice and what the potentials are for integrating STD/HIV management into MCH/FP services in Ghana to improve reproductive health. This thesis argues that all elements of policy and policy analysis are located within a 'contextual framework' and are influenced by a range of contextual factors (defined and illustrated through the thesis) which are seldom taken into account in policy process and analysis. It is argued that understanding the different levels of context is fundamental to understanding the processes of policy development and implementation, the actions of actors at all levels and the policy outcomes. Using a multi-level focus and a combination of approaches, this thesis identifies the contextual factors and their manifestations at each level of the policy process and illustrates how they impact on policy. The analysis synthesises macro and micro dimensions gaining a more comprehensive understanding of the influences on and gaps between policy development and implementation. At the implementation level, 27 clinics were visited and 94 clinic staff interviewed in one rural region of Ghana, to ascertain what STD/HIV management services are actually being provided and what factors influence service provision (policy implementation). Interviews with community leaders and focus groups with villagers were conducted in the same region to explore community perspectives of disease and health care services and understand the factors influencing service utilisation (policy outcome). The role of the regional health administration as an intermediary was considered and understanding sought of the concepts of power which influence administrative and management structures. The national level interviews with government and Ministry of Health officials and with donor, NGO and national group representatives, provide further insight into the concepts of power and status and who influences policy making. Finally, all elements are brought together and discussed, a reworked framework is presented and suggestions for future policy and research directions are made.
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Szoke, Helen. "Social regulation,reproductive technology and the public interest : policy and process in pioneering jurisdictions /." Connect to thesis, 2004. http://eprints.unimelb.edu.au/archive/00002866.
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Smith, Heather K. "The impact of framing on policy passage: the case of assisted reproductive technology." Thesis, Georgia Institute of Technology, 2011. http://hdl.handle.net/1853/42774.
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In the last 30 years, in vitro fertilization (IVF) has created a significant amount of controversy around the world. Within the U.S., policy movement has been limited, occurring primarily at the state level, which has created a fragmented system of rules to manage the technology. However, there appear to be indications that how the issue is presented, and which actors are chosen to be represented in legislation, may impact the passage of policy, thereby also providing a reason for why little policy movement has occurred. In this study, pieces of federal, California and Georgia legislation were examined for the occurrence of differing frames, as identified by the actors presented, in order to determine whether different frames occurred in passed legislation than those found in failed legislation. It was determined that, while actors did not differ significantly between passed and failed legislation, there were some slight differences between actors used at the federal level, as well between the different state levels. Even further, the presentation of actors and their interests did appear to differ slightly between passed and failed legislation.
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Löfstedt, Petra. "Changing reproductive patterns in rural China the influence of policy and gender /." Stockholm, 2005. http://diss.kib.ki.se/2005/91-7140-554-2/.
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Libasie, M. "Implementation of women's right to reproductive health in Ethiopia : policy and healthcare perspectives." Thesis, University of Surrey, 2017. http://epubs.surrey.ac.uk/813209/.
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Issues related to reproductive health are being increasingly recognised by the international community to contributing greatly towards eliminating gender-based health disparity. And in recent years, normative developments have proliferated both in the international and domestic arena. This thesis showcases the level of implementation of women’s right to reproductive health in Ethiopia. In so doing, it questions the international legal footings of this specific right. Implementation in this context is grappled with various obstacles such as balancing low economic resource setting with fulfilling economically demanding obligations; and/or eliminating entrenched harmful cultural traditions while enhancing acceptability of services. The research adopts a set contextual human rights indicators to sift the legal framework and health system of Ethiopia with a view to assessing the level of implementation. It identifies existing gaps and seeks to forward recommendations.
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Keesbury, Jill E. "Evaluating the effectiveness of the international population regime the politics of post-Cairo policy change in South Asia /." Thesis, University of Hawaii at Manoa, 2003. http://proquest.umi.com/pqdweb?index=0&did=765882831&SrchMode=1&sid=9&Fmt=2&VInst=PROD&VType=PQD&RQT=309&VName=PQD&TS=1209404689&clientId=23440.
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Oronje, Rose Ndakala. "Understanding the drivers of change in sexual and reproductive health policy and legislation in Kenya." Thesis, University of Sussex, 2013. http://sro.sussex.ac.uk/id/eprint/46469/.
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The thesis explored the drivers and inhibitors of change in sexual and reproductive health (SRH) policy and legislation in Kenya. The overall purpose was to contribute to the limited knowledge on national-level debates that shape how developing countries adapt the SRH agenda, which originated from international processes. The thesis explains how and why some SRH reforms have been realised in Kenya amid contention, while others have been blocked. Guided by a synthesis conceptual framework that emphasised the central role of discursive power in decision-making, the thesis adopted a qualitative case-study design enriched with various anthropological concepts. Three case-studies (two bureaucratic, i.e. adolescent RH policy and national RH policy, and one legislative, i.e. sexual offences law) were deconstructed. Data collection involved semi-structured in-depth interviews with policy actors, observations and note-taking in meetings, and document review. Findings revealed that four influential narratives of SRH – the moral narrative, cultural narrative, medical narrative (with two variations i.e. ‘moralised' versus ‘comprehensive' medical narratives), and human rights narrative – underpinned by conflicting actor interests, mediated the interplay of actor networks, knowledge, context and institutions to determine reforms. The findings revealed that the strong entrenchment of the moral and cultural narratives in the Kenyan context (mainly public structures and institutions) was a major barrier to reforms on contested SRH issues. Even then, the hegemonic narratives were in some cases unsettled to make reforms possible. The most important factors in unsettling the hegemonic narratives to facilitate reforms included: a change in the political context that brought in new political actors supportive of reforms, the presence of knowledgeable and charismatic issue champions within political and bureaucratic institutions, the availability of compelling knowledge (scientific or lay) on an issue, sustained evidence-informed advocacy by civil society/non-governmental organisations, donor pressure, and reduced political costs (for politicians and bureaucrats) for supporting reforms. The main contribution of the thesis is three-fold. First, the thesis captures the disconnect between international SRH agreements and national-level realities, showing the need for international actors to consider national-level realities that shape decision-making. Second, its findings provide lessons for informing future SRH reform efforts in Kenya and in other sub-Saharan African countries. Third, its analysis of discursive power contributes to a major theoretical gap in health systems research in developing countries identified as lack of critical analysis of power in decision-making.
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Ferreira, Nicole. "Enduring "lateness": biomedicalisation and the unfolding of reproductive life, sociality, and antenatal care." Master's thesis, University of Cape Town, 2016. http://hdl.handle.net/11427/27691.
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The dissertation examines how pregnant women seeking antenatal care at a state facility in the Southern Peninsula of Cape Town conceptualise and experience their pregnancies in relation to the biomedical model that informs state practices of care. I specifically explore the experiences that contribute to the state's definition of 'late' presentation at antenatal clinics (i.e. after the first trimester). The antenatal care model advises that pregnant women report "early", at 12 weeks, and have regular follow up visits up until 40 week period, yet recent public health research showed that women present "late" to the antenatal clinics, with only 40.2% of first antenatal visits occurring in the first trimester in South Africa. The women who were a part of the research were chosen in the clinic space, in waiting rooms, booking rooms and while waiting for ultrasounds. The women were selected based on age (17 upwards), and gestational age at first antenatal booking. I examine the ways biomedicine frames temporality, and the way that health policy enacts this through antenatal care. I contest the brackets of 'lateness' and biomedicalisation of pregnancy, and the state's version of the female reproductive body as I describe the unfolding experiences of a reproductive life, showing how pregnancy and health care seeking are enmeshed in social worlds. The discursive framings of antenatal attendance exhorts women to seek antennal care at 12 weeks gestation, to "be responsible" "good women" managing their sexual and reproductive lives with a mode surveillance that presumes a certain way of knowing and counting the body. I explore the other ways of experiencing, knowing, and counting, showing how pregnancy experiences and healthcare seeking behaviours are influenced by social, economic, political, and historical factors, and by the moral and religious values that shape daily life for women. My thesis is grounded in the growing literature on anthropology of reproduction and the biosocial. In doing so, I examine what it means to have and experience a reproductive body within the unfolding events of everyday life, where moments and 'quasievents' (such as structural inequalities, and the daily bouts of gang violence and domestic violence) become enmeshed, such that they influence temporality, differing perceptions of trust, distrust, risk and testing, and differing social values of testing. I further show how maternal kinship networks of support are valued, yet precarious as are intimate partnerships, which both influence experiences of care, neglect, abuse, punishment and shape antenatal attendance. In contesting temporal boundaries of biomedicine I show how women's bodily and relational experiences, their everyday lives and quasi-events within them are inseparable in shaping antenatal health seeking practices and how pregnancies are imagined.
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Gordon, Christopher Alan. "Reproductive Success of Black Skimmers on an Artificial Island: Effects of Hatching Date and Feeding Rate." W&M ScholarWorks, 1999. https://scholarworks.wm.edu/etd/1539626210.
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McCarthy, Claire Louise. "Women choosing not to have children : implications for social work practice and policy on reproductive choice." Thesis, University of British Columbia, 1989. http://hdl.handle.net/2429/27291.
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The purpose of this research study was to explore the relationship between women who have chosen not to have children and one specific area of social policy, that of reproductive choice. Attitudes toward and access to voluntary sterilization and abortion were emphasized.
A feminist qualitative research approach was used in this study. Based on interviews with ten childfree women and five community agency representatives/professionals, this research explored the experiences and attitudes of childfree women and community representatives toward voluntary sterilization and abortion. A substantive and theoretical coding process was used for data analysis.
The results of this research indicate a discrepancy between what these childfree women expected from the process of obtaining a tubal ligation or abortion versus what actually happened to many of them in their contact with the medical profession. In particular, access to more information and the right to make an autonomous decision became poignant concerns in the study. Balancing the rights of women to voluntarily access abortion and sterilization against the rights of other women to not be coerced to have an abortion or tubal ligation is a challenge for our society. Social workers have a significant role to play both in terms of clinical work in the health field and at the social policy level to ensure that all women have the opportunity to make autonomous reproductive choices.Arts, Faculty of
Social Work, School of
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Cleves, J. C. "Making and implementing reproductive health policy : delivering the Cairo programme of action in India, 1994-1999." Thesis, Swansea University, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.636268.
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This dissertation examines the making and implementation of reproductive health policy in India. Its spatial and theoretical territory is the gap between International Conference on Population and Development held in Cairo in 1994 and the quinquennial review that concluded in a United Nations Special Session in New York in June 1999. Its epistemological territory is the gap between the policy prescriptions of the Programme of Action and their limited realisation in India by 1999. It builds its case by a careful reading of development texts: lack of solid evidence on the ground makes it very difficult to examine concrete evidence of impact, though the dissertation includes a detailed case study of the implementation of a reproductive health project in the state of West Bengal. In seeking to understand the nature of the gap between policy and practice, the dissertation traces in detail the events between 1994 and 1999, particularly those of key actors engaged in creating the new public sector discourse of reproductive and child health - the Government Ministry of Health and family Welfare, the World Bank, the European Commission, and other external agencies, such as the UK Overseas Development Administration (later the Department for International Development (DFID)), as well as Indian commentators. In the process it asks questions about policy making and the implementation, asking whether the gap between policy and practice was a result of poor policy prescriptions and implementation, a more general problem of development cooperation, or an inevitable consequence of the ideological and political nature of policy making. It concludes that international policy 'skyscrapers' such as the Cairo Programme of Action cast shadows over the landscape behind them, which inevitably masquerade as gaps between policy and practice. Better understanding the ideological nature of policy, and the real content of this apparent gap provides a starting point for a more appropriate agenda for development cooperation.
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Onasoga, Olayinka Abolore. "Challenges and barriers to adolescents' post-abortion care services: Implications for reproductive health policy in Nigeria." University of the Western Cape, 2017. http://hdl.handle.net/11394/6503.
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Philosophiae Doctor - PhDThe prevention of abortion related complications and mortality is dependent on the availability, accessibility and usability of emergency post-abortion care (PAC) throughout the health care system. Unfortunately, abortion is not legal in Nigeria and Nigerian women, especially adolescents, are often unable to obtain adequate post-abortion care services due to a variety of reasons. A review of literature shows that adolescent PAC patients receive worse care than older women seeking PAC services. There is widespread recognition of the need to overcome these barriers and make it easier for women to obtain the PAC services they need. Therefore, overall aim of this research study was to provide empirical information on the barriers and challenges to adolescents' PAC and develop a policy document to inform reproductive health services for Nigerian hospitals. To develop this policy document, the study specifically sought to assess knowledge of reproductive-health and related post-abortion care services among health care providers; describe the adolescents' perception of post-abortion care received; determine the service providers' perspectives on adolescents' post-abortion care challenges and barriers; analyze the challenges and barriers faced by adolescents in obtaining post-abortion care services; explore ways in which the knowledge about challenges and barriers to adolescents' post-abortion care can be used to inform policy; develop policy document and make recommendations in key areas to improved PAC services in Nigeria as part of working towards improving reproductive health services.
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Hale, Nathan L., Wondimu S. Manalew, Edward Leinaar, Amal J. Khoury, and Michael G. Smith. "Contraceptive Use Among Reproductive-Age Women Gaining Access to Medicaid and Associations With Pregnancy in South Carolina, 2012-2016." Digital Commons @ East Tennessee State University, 2020. https://dc.etsu.edu/etsu-works/8177.
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Wang, Li. "Cultural Representations of the One-child Policy in Chinese Literature and Film since 1978." Thesis, University of Oregon, 2016. http://hdl.handle.net/1794/20558.
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This dissertation focuses on the cultural representations of the one-child policy ever since 1978. The artistic discourses about the one-child policy provide a fantastic space to explore China’s post-socialist society and contending ideologies. It also sheds light on the intricate relation between aesthetics and politics and these among the state, family and individual. Moreover, as discourses, artistic narratives and images also participate in the redefining of reproduction/one-child policy. Therefore, inquiries into the interaction between aesthetics and politics enrich our understanding of how reproductive ideals are constructed, negotiated and transformed.
This dissertation can be divided into five parts. In the introduction part, I introduce issues related to the one-child policy, materials which I use and my main approaches to interpret them. Chapter Two explores how post-1978 family planning films and novel envision the ideal reproductive lives of peasants through the construction of ideal reproductive subjects, especially ideal female models. These artistic works also show changed representations of the ideal role models. Chapter Three looks into the patriarchal reproductive subject in Mo Yan’s Frog which centers on the conflict between state power and traditional male-centric reproductive culture. Although there are ambiguities, the novel demonstrates that the state has failed to transform peasants’ traditional reproductive ideas. Chapter Four deals with women’s exploration of reproduction from the 1980s on. The writings of some female authors demonstrate a consciousness of independent female reproductive desire. In some works, we can even see the emergence of a new kind of female reproductive privacy. In these works, reproduction becomes the female protagonists’ personal, private matter and women’s subjectivity is seen in their ability to make reproductive decisions according to their own interests. In the Coda, I talk about my future research plans.
Overall, in this dissertation, I trace the political, economic, cultural, and technical factors that contribute to the gradual emergence of pluralism in reproductive ideas and practices. My dissertation demonstrates the dynamic interaction among different forces affecting reproduction, one of the most strictly controlled realms in Chinese life. Although reproduction is still mainly dictated by the state current two-child policy, a push towards greater individual autonomy is starting to gain momentum.10000-01-01
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Tinnerholm, Ljungberg Helena. "Omöjliga familjen : Ideologi och fantasi i svensk reproduktionspolitik." Doctoral thesis, Stockholms universitet, Statsvetenskapliga institutionen, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:su:diva-122219.
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The relationship between the state and the people is a central theme in political theory. Discussions in this field have often centered on how a people can come to constitute a state. Less attention, however, has been directed toward the state’s role in constituting and recreating its people. This book examines the Swedish state’s role in forming the people by regulating the use of reproductive techniques: insemination, in vitro fertilization (IVF), and donations of sperm and eggs. The study focuses on how the issue of assisted reproduction was handled and problematized in Swedish policymaking between 1981 and 2005. What problem representations dominated the political debates and decision-making processes surrounding assisted reproduction? How was conflict expressed within the field of reproductive politics (i.e., what aspects caused conflict or political disagreement)? How did collective fantasies play into the political treatment of reproductive technologies? Using historical government and Riksdag material, four major policy debates have been analyzed, from the first legal regulation of assisted reproduction in Sweden in the 1980s up until the inclusion of lesbian couples as beneficiaries of gamete donation. Theoretically, the study is inspired by Ernesto Laclau and Chantal Mouffe’s political discourse theory, Lacanian psychoanalysis, and the “logics approach” developed by Jason Glynos and David Howarth. This combination of perspectives allows for a dual focus on both the form of political articulations and their affective force. Thus, the analysis tries to capture what was taken for granted within the discourse on reproduction (social logics), what arose as points of political conflict or contention (political logics), as well as the affective underpinnings of these social constructions and struggles (fantasmatic logics). The main result of the study is that even though the period saw a quite revolutionary development of new reproductive technologies, the reproduction policies under study took on much more moderate and hesitant character. Throughout the analyzed period there was a more or less consensual view that new reproductive technologies should only be allowed if they did not go against the “child’s best interest.” At the same time, there was significant political conflict over what constituted this interest. Moreover, the reforms that were made never fully embraced the radical implications of the new technologies. Rather, they clung on to previously established patterns of what a “real” family looked like. Thus, every move to allow a new technology or include another category of people as legitimate users of that technology was contingent upon the articulation of a discursive equivalence with previously naturalized methods of reproduction, ultimately taking the heterosexual, nuclear family as an implicit model. Finally, I argue that the production of “sense” in this terrain of radical undecidability was dependent on the mobilization of a series of collective fantasies about “natural life processes,” “nature’s imperfections,” “a humanist view of mankind,” “the stable, original nuclear family”, and so on.
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Moore, Sarah-Ann. "Policy responses to the sexual and reproductive health of queer youth in the global south: a systematic review." Thesis, Rhodes University, 2018. http://hdl.handle.net/10962/63021.
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Concerns surrounding youth sexual and reproduction health (SRH) are deeply embedded within systems of heteronormativity and ciscentrism. Resultantly, youth SRH is filtered through a lens of heterosexual and cisgender experience, rendering invisible the SRH needs of queer youth. Importantly, a failure to recognise queer experiences of SRH has implications for normative subject positions, which enjoy stronger institutional support and constitute legitimate ways of being. As such, the failure to recognise queer youth as health care subjects within policy has far reaching consequences for their sexual and reproductive health. Within this research, a sexual and reproductive justice (SRJ) framework is adopted as a backdrop for exploring policy documents related to youth SRH within selected global South countries in Africa, Asia, and the Caribbean. The final data set comprises of 1035 policy excerpts extracted from 152 policies across these three regions. Research takes the form of a systematic review utilising a deductive framing and positioning thematic analysis. Analysis identifies framings of youth SRH and explores the subject positions assigned to queer youth in relation to these identified framings, with the understanding that the manner in which youth SRH concerns are framed and queer youth are positioned within policies provides an important foundation for the implementation of SRH-related policy. Findings demonstrate that policy responses to youth SRH are most often framed in terms of a public health approach. As a result, dominant understandings of youth SRH serve to reduce youth sexuality to notions of infections and impact, which may speak to an overreliance on biomedical and population-level health models. Themes emerging within human rights framings demonstrate a presumption that rights are equally afforded to, and freely exercised by, all individuals once legally secured, failing to engage with the creation of enabling conditions to realise these rights. Although context and culture framings were by no means exhaustive examples of SRJ, they provide an interesting insight into how such SRJ concerns might be integrated into policy. Importantly, policy responses demonstrate a general pattern hypervisibility of men who have sex with men (MSM) standing in marked contrast to the invisibility of queer youth and other adult queer populations. Within policy extracts, both youth and „MSM‟ are positioned as particularly prone to poor SRH outcomes. By virtue of their inclusion within both populations, queer youth may be considered as especially at risk for, or vulnerable to, such outcomes. Relatedly, these populations (and by extension queer youth) are positioned as in need of correction, containment, and/or protection by those occupying „gatekeeping‟ positions (e.g. health care providers). The positioning of „MSM‟ solely within the context of HIV/AIDS serves to link same-sex sexualities (and at times gender non-conformity) with harmful consequences, suggesting that the positioning of queer youth could similarly serve to conflate their SRH needs with concerns around HIV/AIDS. Many of the subject positions deployed in policies serve to deny the potential for youth and „MSM‟ agency, strength, and resilience. Thus, queer youth subjects are unlikely to be positioned as empowered, autonomous, and agentic. Across both framing and positioning themes, a number of key shortcomings were observed. For the most part, policy responses fail to acknowledge the influence of social, economic, political, and cultural forces that may serve to hinder SRH outcomes according to particular contexts and the intersection of multiple and varied social identities. By obscuring these broader contextual factors and power relations, policy responses may serve to hold individual youth responsible for poor SRH outcomes. In failing to engage with the potential for diversity within youth populations, these populations are largely homogenised. Finally, the need for the creation of an enabling environment in order to secure sexual and reproductive health is largely unacknowledged within policy responses.
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Farahani, Farideh Khalaj Abadi. "Norms, attitude and sexual conduct among female college students in Tehran : implications for reproductive health policy and research." Thesis, London School of Hygiene and Tropical Medicine (University of London), 2008. http://researchonline.lshtm.ac.uk/682381/.
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Despite social, cultural and religious prohibitions on premarital sexual relationships in Iran, some evidence suggests that premarital heterosexual relationships and sex among young people may be increasing, but no study has been conducted which gives a comprehensive picture of perceived societal norms, attitudes, sexuality and the nature and process of heterosexual relationships among unmarried young females in Iran. This study aimed to investigate and compare the views and conduct of young female college students with perceived societal norms. The objectives included; exploring sexual norms and attitudes, assessing the social and individual factors responsible for variation in norms, attitude, and behaviour of female college students and finally exploring the process and circumstances of sexual behaviour. Complementary qualitative and survey methods were used. The qualitative research includes 4 Focus Group Discussions (FGDs) and 30 In-Depth Interviews (IDIs). FGDs explored societal norms on pre-marital sexuality, while IDIs explored more personal attitudes and behaviours in greater depth. The survey was conducted in 2005-6 on a sample of 1743 female undergraduate students in four multidisciplinary universities in Tehran. A self-administered questionnaire was applied. This study revealed an ambiguity with regard to social acceptability of premarital heterosexual relationships, while sexual contact before marriage was perceived as socially proscribed. Personal attitudes were considerably more tolerant of such premarital relationships and sex than societal norms. These findings suggest that traditional norms on heterosexual relationships are eroding among young people. Within this complex attitudinal context, nearly half of unmarried women reported premarital friendships with men and more than one-fifth reported any type of sex (23%). Low self-efficacy, peers' liberal norms on virginity, older age, parents' liberal attitude and poor family relationships were predictors of ever having sexual contact. Qualitative findings showed that gender double-standards dictate restrictions for women, but permit sexual licence for men and owing to men's preference for a virgin bride, most relationships which involve sex are unlikely to result in marriage. Therefore although young people have adopted some liberal values in their premarital relationships their marriage still follows traditional and cultural values. These results have implications for programmes designed to improve young people's reproductive health in Iran.
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Hadi, Manizha. "An analysis of policy and social factors impacting the uptake of sexual and reproductive health services in Kabul, Afghanistan." Thesis, Durham University, 2016. http://etheses.dur.ac.uk/11862/.
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Research Question: What factors at individual, health service provision and system levels are influencing sexual and reproductive health (SRH) service uptake? Rationale: In many Afghan ethnic groups, girls and women face heavier risks of disease and infection than men. Their diminished economic and social status compromises their ability to select healthier life strategies and access to sexual reproductive health (SRH) services. The Afghan government estimates a high maternal mortality ratio (327/100,000 live births) in Afghanistan. However, due to inadequate reliability of data, the true maternal mortality and morbidity ratio remain unknown. A deeper understanding of the policy and social factors that impact on poor SRH service uptake would help the development of applicable and successful SRH Policy and frame applicable and appropriate approaches for sustainable SRH service uptake in Afghanistan. Method: It is a qualitative policy analysis using the ‘Broader Framework of Thinking’ by Walt and Gilson (1994) and a variety of data collection methods. Data was collected from 450 participants (Patients 223, Family members 72, Health service providers 63, Governmental staff 31, Coordinating organisation staff 17, Religious leaders 11, Health-promoters 13, Psychosocial counsellors 20) by conducting interviews, focus group discussions, participant observation, life narratives, document reviews and an audit of medical records. Findings: My results show the key factors underlying women’s poor health were a lack of knowledge about SRH, poor communication, and a lack of honour and trust both between individuals and within the health system. In addition, research findings highlighted that depression, multi-pregnancies, childbirth complications, anemia, malnutrition, sexually transmitted infections and interpersonal violence were routine for women. It clearly shows gaps within SRH Policy design and implementation and health service provision. These gaps are associated with social factors, which negatively impact on access and utilisation of proper SRH services Conclusions and Recommendations: This research analysed national reproductive health Policy (NRHP) and explored the impact of multifaceted social factors on SRH service uptake. In complex health systems recommending solutions require distinguishing between types of problems and a specific time-scale to improve SRH service uptake.
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Jimenez, Stephanie. "Social Constructions of Teen Pregnancy: Implications for Policy and Prevention Efforts." Scholarship @ Claremont, 2012. http://scholarship.claremont.edu/scripps_theses/50.
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Over the past few decades, teen pregnancy has been framed as one of society’s most pressing ills. It has been understood as a “crisis” by The National Campaign to Prevent Teen and Unplanned Pregnancy and a number of other cultural, religious, and governmental institutions. In this thesis, I analyze three constructions of teen pregnancy: 1) the construction of teen mothers as social “burdens” 2) the construction of teens as “unfit” to be parents 3) the construction of teen mothers as collectively “rational” actors reacting to contexts of structural inequality. While the first and second constructions draw upon the conception of teen pregnancy as a costly, national epidemic often reproduced by the irresponsible and “deviant” behavior of teens, the last construction rejects this discourse, and posits adolescents as “rational” actors that make “rational” decisions given a context of structurally-produced inequality. In that early childbearing may serve as a “collective adaptive” strategy in contexts of poverty, this construction of teen pregnancy has attempted to deconstruct the notion that teens become pregnant due to their “irrationality,” or their inability or unwillingness to recognize the harsh repercussions of early childbearing.4 In that this third construction favors “empowerment” policies that provide women with the “knowledge and means to exercise reproductive freedom,” it does not narrowly promote prevention policy as a single approach to teen pregnancy, and escapes the promotion of punitive approaches that seek to scare and discipline teens into abstaining from non-marital sex.
4 Arline T. Geronimus, “Teenage Childbearing and Social Disadvantage: Unprotected Discourse,” Family Relations (April 1992): 245.
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Huber, Karen E. "Sex and its consequences: abortion, infanticide, and women’s reproductive decision-making in France, 1901-1940." The Ohio State University, 2007. http://rave.ohiolink.edu/etdc/view?acc_num=osu1187032776.
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Crain, Stacie M. "Designer Genes: An analysis of a theoretical framework for policy proposals in relation to genetic engineering as a reproductive technology." Thesis, Virginia Tech, 2003. http://hdl.handle.net/10919/44317.
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With the new capabilities of genetic engineering and such biotechnologies, come added considerations for policy makers. If gene therapy (or even embryo selection) becomes common practice, we must look not only to creating policies that protect the interests of individuals in the legal and social realms, but consideration must also be given to the equality of opportunity in the genetic sense. This additional level brings with it much significance; one can argue that financial disparity is at least theoretically surmountable but it is difficult to account for intentional genetic alterations that would forever give certain individuals a physical advantage over non-enhanced persons.
It is with these new boundaries that genetic policy must find itself creating legislation; it is also with these new boundaries that policy will find its greatest hurdles. Given the ever-expanding field of biotechnology and gene therapy, one can hardly expect policy written today to be up-to-date ten, or even two years from now. Instead of focusing, therefore, on specific recommendations, I will center my discussion on a broad framework that outlines the arguments that should be considered when dealing with genetic engineering and public policy.
After creating a theoretical structure centered on historical experiences and the philosophical writings of John Rawls, we will delve deeper into the actual possibilities created by genetic engineering and embryo selection. I will further analyze the differences between positive and negative genetic interventions and discuss the consequences of these differences as they should (or should not) affect policy. This particular distinction and the implications of these differences on policy will serve as the bulk of my discussion.Master of Arts
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Lindeborg, Alicia. "Representation and its importance for women's sexual and reproductive health and rights : Does the proportion of women in national parliaments matter for the extent to which legislation and policy guarantee women's sexual and reproductive health and rights?" Thesis, Uppsala universitet, Statsvetenskapliga institutionen, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-432522.
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This thesis sets out to investigate if the proportion of women in the national parliament correlates with the extent to which national laws and policies guarantee women's sexual and reproductive health and rights. By conducting a cross-national comparison, this thesis contributes to the existing literature by offering an analysis of the relationship, utilizing a comprehensive measurement of states national legal and regulatory framework relating to women's sexual and reproductive health and rights. Further, it aims to offer an analysis of how the relationship appears in different regime-types, including both democratic and non- and partial democratic states. The results did not provide any support for a correlation between the proportion of women in the national parliament and the extent to which national laws and policies guarantee women's sexual and reproductive health and rights, regardless of the regime-type. While the results are inconsistent with the predictions of a correlation, this thesis is able to conclude that the concept of women's representation and how it may be connected to substantial changes in national legislation and policy is a complex relationship, worthy of further research.
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Marniari, Kadek. "Is a right to abortion protective of women's reproductive health? : exploring a human rights dynamic of abortion law reform in Indonesia /." Oslo : Faculty of Law, Universitetet i Oslo, 2008. http://www.duo.uio.no/publ/jus/2008/80151/Thesis_DUO.pdf.
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Leinaar, Edward, Billy Brooks, Leigh Johnson, and Arshman Alamian. "Perceived Barriers to Contraceptive Access and Acceptance Among Reproductive-Aged Women Receiving Opioid Agonist Therapy in Northeast Tennessee." Digital Commons @ East Tennessee State University, 2020. https://dc.etsu.edu/etsu-works/8152.
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strong>Objectives: Women with substance use disorders experience unique challenges to contraceptive obtainment and user-dependent method adherence, contributing to higher than average rates of unintended pregnancy. This study estimated the prevalence of barriers to contraception and their associations with contraceptive use and unwanted pregnancies among women receiving opioid agonist therapy (OAT) in northeast Tennessee.
Methods: A cross-sectional survey was piloted among female patients aged 18 to 55 years from 2 OAT clinics. Logistic regression was used to evaluate associations between contraceptive barriers and current contraceptive use and previous unwanted pregnancies among women receiving OAT.
Results: Of 91 participants, most experienced previous pregnancies (97.8%), with more than half reporting unwanted pregnancies (52.8%). Although 60% expressed a strong desire to avoid pregnancy, ambivalence toward becoming pregnant was common (30.0%). Most experienced ≥1 barriers to contraceptive use or obtainment (75.8%), the most prevalent being aversion to adverse effects (53.8%), healthcare provider stigmatization (30.7%), scheduled appointment compliance (30.3%), and prohibitive cost (25.0%). Experience of any contraceptive barrier (adjusted odds ratio [AOR] 8.64, 95% confidence interval [CI] 2.03–36.79) and access to a contraceptive provider (AOR 5.01, 95% CI 1.34–18.77) were positively associated with current use of prescribed contraceptives, whereas prohibitive cost was negatively associated (AOR 0.28, 95% CI 0.08–0.94).
Conclusions: Although most participants desired to avoid pregnancy, ambivalence or uncertainty of pregnancy intention was common. Most experienced barriers to contraception, which were more strongly associated with previous unwanted pregnancy than current contraceptive use. The provision of long-acting reversible contraceptives and contraceptive education at OAT clinics represents an opportunity to reduce the incidence of neonatal abstinence syndrome.
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Sloan, Tyler E. "The Abortion Burden: Examining Abortion Access, Undue Burden and Supreme Court Rulings in the United States." Oberlin College Honors Theses / OhioLINK, 2017. http://rave.ohiolink.edu/etdc/view?acc_num=oberlin1494418153379172.
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Leinaar, Edward, Billy Brooks, Leigh Johnson, and Arsham Alamian. "Perceived Barriers to Contraceptive Access and Acceptance Among Reproductive-Aged Women Receiving Opioid Agonist Therapy in Northeast Tennessee." Digital Commons @ East Tennessee State University, 2019. https://dc.etsu.edu/etsu-works/8182.
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backgroundWomen with opioid use disorder (OUD) experience unique barriers to contraception, contributing to higher than average rates of unintended pregnancy. Rates of neonatal abstinence syndrome (NAS), a drug withdrawal syndrome resulting from antenatal drug exposure, are higher in Tennessee than the nation. Few studies have quantified experience of contraceptive barriers or their associations with contraceptive use among women with OUD.
objectives This study estimated prevalence of barriers to access/acceptance of contraceptive services and their associations with current contraceptive use and unwanted pregnancy among reproductive-aged women in Northeast Tennessee receiving opioid agonist therapy (OAT).
methods A cross-sectional survey was administered to female patients aged 18-55 from two OAT clinics. Logistic regression was used to evaluate associations between contraceptive barriers and current contraceptive use and previous unwanted pregnancies.
results Of 91 participants, most were insured (84.4%), experienced at least one barrier (75.8%), and more than half reported unwanted pregnancies (52.8%). Most desired to avoid pregnancy (60.0%) or were ambivalent (30.0%). Common barriers were side effect aversion (53.8%), provider stigmatization (30.7%), appointment compliance (30.23%), and cost (25.0%). Experience of any barrier (AOR=11.6, 2.25-59.8) and access to a contraceptive provider (AOR=9.78, 1.34-71.7) were positively associated with use, while cost was negatively associated (AOR=0.27, 0.07-0.98). Eight barriers were significantly associated with unwanted pregnancies.
conclusionWhile most participants desired to avoid pregnancy, contraceptive barriers were common. Barriers were more strongly associated with previous unwanted pregnancy than current contraception. Contraceptive provision at OAT clinics may reduce incidence of unwanted pregnancy and NAS in Northeast Tennessee.
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Cusanno, Brianna Rae. "“It’s A Broken System That’s Designed to Destroy”: A Critical Narrative Analysis of Healthcare Providers’ Stories About Race, Reproductive Health, and Policy." Scholar Commons, 2019. https://scholarcommons.usf.edu/etd/7771.
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Constructions of race, reproductive health, and gender have been inextricably linked in the United States since the beginning of the nation. Today, these linkages remain evident in the marked racial and gender inequities in reproductive health outcomes that persist in the U.S. To better understand how these meanings and material outcomes are negotiated and produced by actors on the ground, this study asked: “How do reproductive healthcare providers (RHPs) communicate about the intersections of race, reproductive health, and policy?” I conducted semi- structures interviews with 24 RHPs, resulting in over 35 hours of recorded interviews. Drawing on critical-cultural communication, Reproductive Justice, Narrative Medicine, and Postcolonial theories, I developed a novel approach to narrative inquiry—Critical Narrative Analysis—to explore my data. Here, I present an in-depth analysis of 8 narratives shared by my participants. I conclude that participants communicated about race, reproductive health, and policy by engaging with dominant cultural narratives around these topics. While some participants contested dominant narratives, most upheld the foundational logics of oppressive systems in the stories they shared. To advance reproductive justice, I argue that new approaches to teaching clinicians, which engage with both narratives and sociopolitical structures affecting these narratives, are needed. By sharing my participants’ stories and contextualizing them within dominant narratives and social institutions, I aim to identify future research and practice opportunities for creating new stories about reproductive health and physician identity, stories which could suggest more equitable and just ways of doing reproductive health care.
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Kamugumya, Denice Cyprian. "Health system's barriers hindering implementation of public-private partnership policy in the health sector at district level: A case study of partnership for improved reproductive and child health services provision in Bagamoyo district, Tanzania." Master's thesis, University of Cape Town, 2015. http://hdl.handle.net/11427/15546.
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The role of the private sector in improving health systems performance in lower to middle income countries is increasingly gaining more recognition. Public-private partnership (PPP) has been suggested as a tool, to assist governments fulfil their responsibilities in the efficient delivery of health services. In Tanzania, although the idea of PPP has existed for many years in the health sector, there has been limited coordination, especially at a district level - which has contributed to limited health gains or systems strengthening obviously seen as a result of PPP. In 2009 a formal PPP policy was introduced in Tanzania, which directs the appropriate allocation of resources, and describes risk and rewards that can be achieved by building on the expertise of each partner. The Health Sector Strategic Plan III (2009-2015) further emphasises the need for service level agreements (SLAs), which are seen as an important indicator of improved PPP. This case study that draws on the decision-space framework, was conducted in the Bagamoyo district of Tanzania, and employed in-depth interviews, document reviews, and observations methods. The study findings reveal several forms of informal partnerships between the local government and non-state actors. The lack of SLAs for facilities that receive subsides from the government is argued to contribute to inappropriate distribution of risk and reward leading to moral hazards. This is evidenced by non-state actors who pursue their own interests, diverting from public social goals. Furthermore, findings highlight weak capacity of governing bodies to exercise oversights and sanctions, which is acerbated by weak accountability linkages and power differences. Moreover, restricted flexibility in spending is seen to deter prompt actions to address evolving population needs, given limited local fiscal space. It is concluded that effective PPP policy implementation at a local level depends on the capacity of local government officials to make choices that would embrace relational elements dynamics in strategic plans. Disempowered Council Health Services Board in relation to engaging non-state actors is shown to impede PPP initiatives that are conceptualized at local and national levels. This study highlights a need to consider initiatives that would foster new social contracts with non-state actors at the local level and in return build a people-centred district health system. This study is intended to improve knowledge on health systems policy interventions, strengthen future policy implementation at the sub-national level, and strengthen the district health systems as a result of PPP in a country with similar contextual elements.
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Leinaar, Edward, Leigh Johnson, Ruby Yadav, Abir Rahman, and Arshmam Alamian. "Healthcare Access, Pregnancy Intention, and Contraceptive Practices Among Reproductive-Aged Women Receiving Opioid Agonist Therapy in Northeast Tennessee." Digital Commons @ East Tennessee State University, 2019. https://dc.etsu.edu/etsu-works/8153.
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Objectives: Women with substance use disorders often experience unique challenges to obtaining contraception and adhering to user-dependent methods. As a result, this at-risk population of women tends to have higher than average rates of unintended pregnancy. The objective of this study was to describe contraceptive use, pregnancy intentions, and adequacy of access to reproductive healthcare among women receiving opioid agonist therapy in northeast Tennessee.
Methods: A cross-sectional survey was piloted among female patients aged 18 to 55 years from two opioid agonist therapy clinics. Descriptive analyses were conducted using logistic regression to evaluate the statistical significance of bivariate associations.
Results: Of 91 participants, 84% reported having health insurance, with 70% perceiving having adequate access to health care. More than half had a history of unwanted pregnancy (53%), among whom few (23.1%) reported the consistent use of contraception at time of conception. Although most desired to avoid pregnancy (90%), only 59% of women reported the current use of regular contraception. Most of those not using regular contraception believed that they were not at risk for pregnancy (54.3%).
Conclusions: Although most participants reported adequate access to health care and a desire to avoid pregnancy, few reported the consistent use of regular contraception. Furthermore, misperceptions regarding pregnancy risk were common among participants. Research is needed to identify barriers to contraceptive acceptance and causes of pregnancy risk misperceptions in this population of women at increased risk of unintended pregnancy.
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Rossi, Andrea da Silveira. "Demanda e barreiras para o acesso a serviços de reprodução assistida de pessoas vivendo com HIV no Brasil : perspectivas de gestores, profissionais e usuários." [s.n.], 2010. http://repositorio.unicamp.br/jspui/handle/REPOSIP/309017.
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Orientadores: Eliana Amaral, Maria Yolanda MakuchTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
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Resumo: Objetivo: Identificar quais Serviços de Reprodução Assistida (SRA) e Serviços de Assistência Especializada em HIV e Aids (SAE) do Sistema de Saúde Pública do Brasil, que oferecem atendimento a pessoas vivendo com HIV com desejo reprodutivo e descrever as vivências, informações adquiridas e barreiras encontradas pelos gestores de programas, profissionais de saúde e usuários, relacionados a essa demanda. Metodologia: Estudo descritivo, de corte transversal através de entrevistas telefônicas com 69 gestores dos programas de saúde da mulher (PSM) e 69 de DST/Aids, estaduais e municipais associado a estudo de casos através de entrevistas semi-estruturadas com profissionais e usuários soropositivos de um serviço de reprodução assistida (SRA) e um serviço de atenção especializada em HIV/Aids (SAE) por região geográfica do país. Foi realizada análise descritiva dos dados quantitativos e análise temática do conteúdo para os dados qualitativos. Resultados: Foram realizadas 64 entrevistas com gestores dos PSM, sendo identificado apenas um SRA universitário que atendia casais soropositivos. Nas 63 entrevistas realizadas com gestores dos Programas de DST/Aids, constatou-se que 64% dos SAE estaduais e 73% dos municipais ofereciam orientação reprodutiva. As dificuldades relatadas pelos gestores para não oferecimento de apoio à reprodução incluíram falta de decisão política, de recursos humanos e financeiros. Nas entrevistas com os profissionais dos seis SAE visitados, foi observado que o foco dos atendimentos era na prevenção, principalmente através do uso do preservativo. A falta de encaminhamentos apropriados e a desatualização do conhecimento científico foram frequentes nos relatos dos profissionais dos serviços. A dificuldade em falar sobre o desejo reprodutivo nas consultas foi observada nas falas dos profissionais e também dos usuários. Para os últimos, isso esteve associado ao medo da discriminação e do preconceito. Entretanto, através da 47 entrevistas realizadas com usuários, o desejo de ter filhos foi vivenciado de maneira natural e expresso independentemente de se ter ou não parceiro fixo, mas, para aqueles que possuem parceiros fixos, o fato de não ter filhos da atual união pareceu aumentar a intenção reprodutiva. Conclusão: Os resultados sugerem a existência de demanda reprimida para reprodução de casais vivendo com HIV, a falta de aconselhamento reprodutivo nos SAE e de investimento em SRA que atenda a essa população, havendo um único SRA universitário no país que oferece esse tipo de atendimento. A falta de integração entre os vários setores sugere a ausência de políticas públicas voltadas para o aconselhamento reprodutivo e a necessidade de diretrizes nacionais específicas voltadas para a redução da transmissão do HIV durante todo o contexto reprodutivo
Abstract: Objective: To identify assisted reproductive services(ARS) and specialized HIV/AIDS services within the Brazilian public health system that provide care to people living with HIV who desire a child and describe the experience, the information, and the barriers encountered by program managers, healthcare professionals and users with respect to this demand. Methods: A descriptive, cross-sectional study in which 69 women's healthcare program managers and 69 STD/AIDS program managers at both state and municipal level were interviewed by telephone, in association with a case study conducted through semistructured interviews with professionals and users of one ARS service and one HIV/AIDS service in each geographical region of the country. Descriptive analysis of the quantitative data and thematic content analysis of the qualitative data were performed. Results: Sixty-four interviews were conducted with women's healthcare program managers. Only one university ARS provided care to seropositive couples. Of the 63 interviews carried out with STD/AIDS program managers, 64% of the state and 73% of the municipal HIV/AIDS services were found to offer reproductive counseling. The difficulties offered by managers as reasons for not providing reproductive support included a lack of political decision and of human and financial resources. At the six HIV/AIDS services the professionals revealed that the focus of consultations was on the prevention, lack of appropriate referrals and outdated scientific knowledge were frequently reported. Difficulty in discussing reproductive issues was perceived in the interviews with the professionals and also with the users. In the latter case, this was associated with a fear of discrimination and prejudice. Nevertheless, as shown in the 47 interviews conducted with users, the desire to have a child was experienced as a natural part of life and was expressed irrespective of whether the individual had a steady partner or not; however, in the former case, the fact of not having a child with the individual's current partner appeared to increase the desire for a child. Conclusion: These findings suggest the existence of a repressed demand for reproduction of PLWHA and lack of reproductive counseling was observed at all HIV/Aids specialized services, as well as investment in ART services to be provided to HIV-positive couples, based on the finding that only one university ART service in the country offers this type of care. Lack of integration between the various sectors suggests an absence of public policies on reproductive counseling and a need for specific national guidelines aimed at reducing HIV transmission within the whole context of reproduction
Doutorado
Ciencias Biomedicas
Doutor em Tocoginecologia
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Leiva, Rioja Zoila. "Public policies of sexual and reproductive health in Peru: the introduction of therapeutic abortion regulation into the government’s political agenda." Politai, 2016. http://repositorio.pucp.edu.pe/index/handle/123456789/91986.
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The objective of the present article is to analyze the process of introducing the regulation of therapeutic abortion into the peruvian governmental agenda, identifying the factors that came together to generate such event, the period of study being between the years 2005 to 2014. The investigation corroborates that said event was possible due to the confluence of certain political and institutional factors on the national stages, the strategy of groups in favor (pro-choice) and against (pro-life) the regulation, and international influence.El presente artículo tiene como objetivo analizar el proceso de ingreso de la reglamentación del aborto terapéutico en la agenda política gubernamental peruana, así como identificar los factores que confluyeron para generar dicho ingreso, siendo el periodo de estudio entre los años 2005 y 2014. La investigación corrobora que dicho ingreso fue posible gracias a la confluencia de ciertos factores políticos e institucionales del ámbito nacional, de las estrategias de los grupos a favor (pro-elección) y en contra (pro-vida) de la reglamentación, y de la influencia internacional.
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Vamos, Cheryl A. "Examining the Title X Family Planning Program’s (Public Law 91-572) Legislative History through a Feminist Lens: A Thematic Analysis and Oral Histories with Key Stakeholders in Florida." Scholar Commons, 2009. https://scholarcommons.usf.edu/etd/64.
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The Title X Family Planning Program (Public Law 91-572), enacted by President Richard Nixon in 1970, provides federal funds for voluntary, confidential family planning services to all women, regardless of their age or economic status. This federal legislation aspired to prevent unintended pregnancies and poor birth outcomes to those in most need. However, over the past three decades, Title X has faced political, financial and social challenges. Despite its enormous success in improving the health and well-being of women and children by decreasing unintended pregnancies, the need for abortions and providing key comprehensive preventive services, without a newfound political will similar to that during which it was conceived, the future of Title X may be in jeopardy.
This study grounded theoretically and methodologically in a feminist policy analysis approach, critically examined the maturation of Title X by employing a mixed methodology design that consisted of a thematic analysis on Title X's legislative history and the conduction and analysis of oral histories. In Phase I, themes were extracted from the federal bills included in Title X's legislative history, which assisted in the identification of the issues that this policy has endured. In Phase II, a semi-structured interview guide was developed based upon the themes and findings from the thematic analysis as well as from pre-determined constructs from McPhail's Feminist Policy Analysis Framework, to explore key informants' perceptions, recollections and experiences regarding the Title X program. By examining Title X through a feminist lens, various issues were exposed and critically examined, including issues that are typically ignored by traditional policy analyses. Moreover, understanding the historical underpinnings and evolutions of a policy and recognizing past failures and achievements are necessary in order to make informed future decisions. Implications for research, practice and policy are discussed.
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Smith, Malcolm. "Regulating IVF and pre-implantation tissue-typing for the creation of "saviour siblings" : a harm analysis." Thesis, Queensland University of Technology, 2010. https://eprints.qut.edu.au/35798/1/Malcolm_Smith_Thesis.pdf.
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Scientific discoveries, developments in medicine and health issues are the constant focus of media attention and the principles surrounding the creation of so called ‘saviour siblings’ are of no exception. The development in the field of reproductive techniques has provided the ability to genetically analyse embryos created in the laboratory to enable parents to implant selected embryos to create a tissue-matched child who may be able to cure an existing sick child. The research undertaken in this thesis examines the regulatory frameworks overseeing the delivery of assisted reproductive technologies (ART) in Australia and the United Kingdom and considers how those frameworks impact on the accessibility of in vitro fertilisation (IVF) procedures for the creation of ‘saviour siblings’. In some jurisdictions, the accessibility of such techniques is limited by statutory requirements. The limitations and restrictions imposed by the state in relation to the technology are analysed in order to establish whether such restrictions are justified. The analysis is conducted on the basis of a harm framework. The framework seeks to establish whether those affected by the use of the technology (including the child who will be created) are harmed. In order to undertake such evaluation, the concept of harm is considered under the scope of John Stuart Mill’s liberal theory and the Harm Principle is used as a normative tool to judge whether the level of harm that may result, justifies state intervention or restriction with the reproductive decision-making of parents in this context. The harm analysis conducted in this thesis seeks to determine an appropriate regulatory response in relation to the use of pre-implantation tissue-typing for the creation of ‘saviour siblings’. The proposals outlined in the last part of this thesis seek to address the concern that harm may result from the practice of pre-implantation tissue-typing. The current regulatory frameworks in place are also analysed on the basis of the harm framework established in this thesis. The material referred to in this thesis reflects the law and policy in place in Australia and the UK at the time the thesis was submitted for examination (December 2009).
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Loaiza, Pamela. "Judicialization of politics in Peru: An observation of the Constitutional Tribunal and its decisions regarding the morning-after pill (2001-2010)." Politai, 2013. http://repositorio.pucp.edu.pe/index/handle/123456789/92587.
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This article analyzes the judicial behavior and the importance of judges in policy making in Peru regarding the case of the magistrates of the Constitutional Tribunal and its decisions regarding the morning after pill. We will focus our research on the shift in orientation of two veredicts issued by this judicial institution; one in favor of its state sponsored distribution (2006) and one against it (2009). In order to analyze the circumstances that led to this two different outcomes, we state that the morning after pill, a case of consciousness, made the judges decide based on their strategic alliances inside the tribunal or their own personal trajectories. In order to solve these dilemmas, the analysis of the kind of judges in the tribunal was crucial to understand the relationship between the elected judges and the interests of political parties in parliament. We believe that the shift in orientation of the veredicts lies in the fact that, for cases of consciousness, the Tribunal uses its sitting judges.Este artículo analiza el comportamiento judicial y la creciente importancia de los jueces en la hechura de las políticas públicas en el Perú a partir del caso de los magistrados del Tribunal Constitucional y sus decisiones frente a la píldora del día siguiente. Nos enfocaremos en el cambio de orientación de dos sentencias emitidas por la máxima institución judicial ante la misma política; por un lado, a favor de su distribución desde el Estado (2006) y, por el otro, en contra (2009). Para analizar los factores que llevaron a este resultado sostenemos que la píldora del día siguiente, al ser un caso de conciencia, les planteó a los jueces la disyuntiva de decidir a partir de un comportamiento estratégico, de acuerdo con las tendencias dominantes al interior del tribunal o haciendo prevalecer sus trayectorias personales. Para resolver estos dilemas, el tipo de jueces que componía el tribunal resultó crucial por lo que exploraremos cómo se configuraron estas composiciones a partir de las bancadas parlamentarias y qué tipo de jueces resultaron electos (de trayectorias públicas u opacas). Sostenemos que el cambio se explicaría porque, para los casos de conciencia, el Tribunal Constitucional utiliza a sus jueces de turno y las reglas así lo permiten.
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Bovill, Catherine. "Rhetoric or reality? : cross-sector policy and practice at the UK Government Department for International Development (DFID) in the UK and Nepal : an exploration of reproductive health and women's education linkages." Thesis, Queen Margaret University, 2005. https://eresearch.qmu.ac.uk/handle/20.500.12289/7454.
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Within the international development community, global agreement around a poverty elimination target and the Millenium Development Goals (MDGs) has led to renewed emphasis on partnership and cross-sectoral approaches. Similarly the UK Government aims to ensure policies are coherent in an increasingly complex global arena and has called for joined-up working. In response to both of these influences, the UK Government Department for International Development (DFID) stresses partnership, joining-up and cross-sectoral approaches within departmental documents. This research explores cross-sector policy and practice at DFID in the UK and Nepal and focuses particularly on cross-sectoral relationships between reproductive health and women's education. The research employs a social constructionist epistemology and utilises Critical Inquiry and Feminist theories, elements of grounded theory and narrative analysis methodologies, informing the use of numerous data collection methods. These methods include literature searches, document analysis, semi-structured interviews (incorporating Participatory Learning and Action techniques), informal meetings and critical reflection. Data was gathered in the UK and Nepal from DFID staff, Nepali Government staff, DFID-funded project staff, external development consultants and other stakeholders. A 'cross-sector continuum model' is presented to facilitate understanding of the different definitions and possible levels of cross-sectoral engagement. Examples of cross-sector policy and practice are presented and discussed. Key factors facilitation cross-sector policy and practice are also identified. The greatest levels of cross-sectoral engagement were found at project-level in Nepal, although the DFID offices had also made some significant efforts to improve cross-sectoral approaches. Poor knowledge and selective use of the reproductive health and women's education research, however, exposed a gap between research and policy. In addition, the reality of cross-sector policy and practice often did not match the rhetoric within DFID's documents. According to respondents, DFID faces some substantial challenges that contribute to these research-to-policy and policy-to-implementation gaps. Despite the increased calls for cross-sectorality, there is little evidence of the benefits of cross-sector policy and practice, suggesting the need for research clarifying the added value of cross-sectoral approaches. Finally, the lack of agreement over cross-sector definitions, the lack of operational guidance and DFID's strong emphasis on outcomes all suggest the need for a reorientation of focus towards cross-sectoral processes. Based on these findings and conclusions, recommendations are made for DFID and other organisations wishing to pursue cross-sectoral approaches.
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L'Espérance, Audrey. "Fertilize-this: Framing Infertility in Quebec, Ontario and England Between 1990 and 2010." Thèse, Université d'Ottawa / University of Ottawa, 2013. http://hdl.handle.net/10393/24288.
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Infertility politics implies a role for the state in regulating the relationships between different parties involved in the medicalized process of reproduction, namely would-be-parents (infertile couples or individuals), gamete donors, surrogate mothers, fertility specialists, etc. Policies adopted by the Canadian federal government in 2004 as regards assisted reproductive technologies (ARTs) were largely inspired by British regulations. Despite this similar start, Canadian policies never lead to implementation; the province of Quebec rapidly contested the federal Assisted Human Reproduction Act before the courts; and many issues of assisted conception were regulated in a heterogeneous manner by the provinces. Meanwhile in Britain, the implementation of the policies created many disparities among the regions of the country; the principle of the law was thoroughly contested and scrutinized; and the sites of deliberation were multiple in spite of the existence of a national regulatory agency. First, the author argues that assisted reproduction technologies cannot be taken as one policy domain, but is an umbrella label for a variety of policy issues. In that context, ARTs are unpacked in order to study, at the system level, the practices related to the overcoming of infertility. I focus on three sub-issues: access to fertility treatments, including the question of public funding and access criteria; gamete and embryo donation, including the question of filiation and donor conceived children’s right to know their biological origins; and surrogacy or the enforcement of pre-natal gestational surrogacy arrangements. Second, by mapping the variety of discourses and arenas mobilized by a range of actors, this study shows how framing and reframing dynamics influence public policies and their implementation. Third, by comparing frame mobilization and discursive dynamics between Quebec, Ontario and England this analysis demonstrates how frame alignment can be a necessary condition for a frame to be performative and influence policy outcomes. Depending on the context in which it occurs, frame transformation, amplification, extension or bridging can induce stability or trigger a cascade of events that will lead to policy change or to a change in the implementation of a policy.
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Sikorski, Christie Danielle. "REPRESENTAÇÕES SOCIAIS DO FILHO BIOLÓGICO CONSTRUÍDAS POR MULHERES QUE, AO VIVENCIAR SITUAÇÕES DE INFERTILIDADE, OPTARAM PELA REPRODUÇÃO HUMANA ASSISTIDA." UNIVERSIDADE ESTADUAL DE PONTA GROSSA, 2014. http://tede2.uepg.br/jspui/handle/prefix/361.
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Previous issue date: 2014-09-19This research aims to analyze the social representations built by the women who experience situations of infertility, opted for the use of assisted human reproduction technologies to realize the biological son. Taking and exploratory qualitative research design, the used methodology has four steps: desk research, literature review, semi-structured interviews and analysis of empirical material. The research base covered services play in the State of Paraná , specifically in the cities of Ponta Grossa and Curitiba; that were being considered by women who chose, after having experienced the process of infertility (either feminine/masculine either ), the use of reproductive techniques with a view to achieving the biological child. Four women were the participants in this study. Following the study, we identified the empirical categories in order to develop knowledge on the subject, under the theoretical framework of Social Representations. The results of the research show that women surveyed attributed to the unique biological son importance. As a life project, his son appeared linked to the ideal of happiness, completeness and have it efforts were not measured (whether financial, emotional or relating to the change in relationships). The statement revealed that experiencing infertility was a painful experience and referred to feelings of frustration, sadness and helplessness. Although the diagnosis of infertility has been reflected both the infertile and for those who experienced the process, reports have shown that the experience was more striking for women. In turn, reproductive technologies have emerged as a solution to the implementation of the biological child. The adoption of the reports also emerged, but only as a second option. The elements of social representations that appeared strongly linked to the son were offspring resemblance, continuity. This research is expected to provide policymakers grants to improve and create policies on assisted reproduction, and particularly, to understand the explanations, meanings and motivations that involve biological motherhood, for the synthesis of this process resulted in the identification of issues that the tangents to the achievement maternity through the use of reproductive technologies ( and their consequences ) deserve special attention both from the government, as the private sphere , it is necessary to strive for realization of reproductive rights, as well as the appreciation of the mother-child relationship.
A presente pesquisa tem como objetivo analisar as representações sociais construídas por mulheres que, ao vivenciar situações de infertilidade, optaram pelo uso das tecnologias de reprodução humana assistida para concretizar o filho biológico. Tendo delineamento qualitativo e caráter exploratório, o percurso metodológico se deu em quatro etapas: pesquisa documental, pesquisa bibliográfica, entrevista semiestruturada e análise do material empírico. O universo de pesquisa abrangeu serviços de reprodução localizados no Estado do Paraná, de forma específica nas cidades de Ponta Grossa e Curitiba, sendo que foram consideradas como sujeitos mulheres que optaram, após terem vivenciado o processo de infertilidade (quer seja feminina/quer seja masculina), pelo uso das técnicas reprodutivas com vistas à realização do filho biológico. Quatro mulheres foram as participantes desta pesquisa. Na sequência do estudo, identificaram-se as categorias empíricas no intuito de elaborar um conhecimento acerca do tema, sob o embasamento teórico das Representações Sociais. Os resultados da pesquisa apontaram que as mulheres entrevistadas atribuíram importância ímpar ao filho biológico. Como projeto de vida, o filho surgiu atrelado ao ideal de felicidade, completude e, para tê-lo, não foram medidos esforços (quer financeiros, emocionais ou ainda relativos à mudança nos relacionamentos). Os depoimentos revelaram que vivenciar a infertilidade foi uma experiência dolorosa e que remeteu aos sentimentos de frustração, tristeza e impotência. Embora o diagnóstico de infertilidade tenha tido reflexos tanto para o infértil quanto para aquele que vivenciou o processo, os relatos demonstraram que a experiência foi mais impactante para as mulheres. Por sua vez, as tecnologias reprodutivas surgiram como solução à concretização do filho biológico. A adoção também emergiu dos relatos, mas apenas como segunda opção. Os elementos de representações sociais que apareceram fortemente ligados ao filho foram: descendência, semelhança física, continuidade. Com esta pesquisa, espera-se oferecer aos formuladores de políticas públicas subsídios para aperfeiçoar e criar políticas sobre reprodução assistida, e, principalmente, compreender as explicações, significações e motivações que envolvem a maternidade biológica, pois a síntese desse processo resultou na identificação de que as questões tangentes à concretização da maternidade por meio da utilização das tecnologias reprodutivas (e suas consequências) merecem especial atenção tanto do poder público quanto da esfera privada, vez que é necessário primar pela efetivação dos direitos reprodutivos, bem como pela valorização da relação mãe-filho.
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Santos, Carolina Orrico. "O processo de formulação da política pública em reprodução assistida: o Projeto de Lei Nº 517/2011, no Estado de São Paulo." Universidade Catolica de Salvador, 2013. http://hdl.handle.net/123456730/286.
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A pesquisa discute o processo de formulação da política pública em reprodução humana assistida, de modo especial o Projeto de Lei nº 517/2011 e sua entrada na agenda governamental do Estado de São Paulo, no intuito de investigar o porquê, como e para que se dá o processo de formulação do “Programa de Assistência Básica em Reprodução Humana” (Projeto de Lei n º 517/2011) na agenda governamental do Estado de São Paulo. Especificamente, buscou-se ainda: identificar o problema que justifica a formulação da política de assistência em reprodução humana assistida no sistema público de saúde do Estado de São Paulo à luz do modelo teórico de política pública de Kingdon; levantar e sistematizar os documentos existentes sobre as propostas/alternativas para a assistência em reprodução humana assistida no sistema público de saúde do Estado de São Paulo; mapear os atores/participantes do processo de formulação da política pública em reprodução humana assistida na agenda governamental do Estado de São Paulo. Assim, este estudo pretende ampliar a compreensão dos direitos sociais, quais sejam: o direito à saúde e o direito sexual e reprodutivo a luz da Lei do Planejamento Familiar, a fim de que as camadas menos favorecidas economicamente possam desfrutar desses direitos, por vezes tolhidos pelo sistema econômico neoliberal e capitalista. Tais direitos auxiliam na construção de um Estado do Bem Estar Social, no qual a cidadania pode ser exercida de maneira salutar à dignidade da pessoa humana. Nesse sentido, a metodologia adotada foi de uma pesquisa qualitativa com revisão bibliográfica, análise documental e o delineamento do estudo de caso, o qual utilizou como instrumento de coleta de dados a entrevista, para buscar a percepção dos atores envolvidos no processo de formulação da política supramencionada, tendo como referencial teórico o modelo de políticas públicas de Kingdon. O caso estudado foi o Projeto de Lei nº 517/2011, que institui o “Programa de Assistência Básica em Reprodução Humana”, da Assembleia Legislativa do Estado de São Paulo. Os dados obtidos evidenciaram que, no Brasil, a política pública ora abordada é escassa, refletindo, pois, no acesso a uma classe menos favorecida. Desse modo, fica evidenciada a necessidade da participação do Estado, através das ações formuladas pelo Sistema Único de Saúde (SUS) ou pelas Parcerias Público-Privadas (PPP). Ressalta-se, entretanto, que as questões orçamentárias para a consecução das políticas de reprodução humana assistida representam empecilhos para sua implementação, devido à limitação dos recursos governamentais, haja vista que a previsão orçamentária ainda é insuficiente. Outrossim, deve-se atentar para o discurso do benefício das privatizações nas prestações dos serviços garantidos constitucionalmente à população como um todo, uma vez que a ausência de regras bem definidas pode favorecer ao desvio dos objetivos reais da referida política, não atendendo, pois, ao público ao qual se destina.
The research discusses the process of public policy-making in assisted human reproduction, particularly the Bill of Law nº 517/2011 and its entry into the government agenda of the State of São Paulo, in order to investigate why, how and who gives the process of formulating the "Basic Assistance Program in Human Reproduction" (Bill nº 517/2011) on the government agenda of the State of São Paulo. Specifically, we sought also to identify the problem that justifies the policy formulation assistance in assisted human reproduction in the public health system of the State of São Paulo the light of the theoretical model of public policy Kingdon; lift and systematize existing documents on proposals / alternatives for assistance in assisted human reproduction in the public health system of the State of São Paulo; map the actors / participants in the formulation of public policy on assisted human reproduction in the government agenda of the State of São Paulo. Thus, this study aims to broaden the understanding of social rights, namely: the right to health and the right to sexual and reproductive Light Family Planning Law, in order that the economically less privileged can enjoy these rights sometimes hampered by neoliberal and capitalist economic system. Rights which help in building a State of Social Welfare, in which citizenship can be exercised so salutary to human dignity. In this sense, the methodology adopted was a qualitative study with literature review, documentary analysis and design of the case study, which used as a tool for data collection interview to seek the perception of the actors involved in the process of policy formulation above, with the theoretical model of public policies Kingdon. The case studied was the Draft Law nº 517/2011, establishing the "Basic Assistance Program in Human Reproduction," the Legislature of the State of São Paulo. The data showed that, in Brazil, the public policy discussed herein is scarce reflecting, as the access to a class less favored. Thus, it is clear the need for the participation of the state through the actions made by the Unified Health System (SUS) or the Public-Private Partnerships (PPP). It is noteworthy, however, that the budget issues for achieving policy assisted reproduction represent impediments to its implementation due to limited government resources, given that even the budget forecast is still insufficient. Furthermore, attention should be paid to the speech of the benefit of privatization in those services constitutionally guaranteed to the population as a whole, since the absence of well-defined rules may favor the deviation of the real objectives of the policy not serving as the public for which it is intended.
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Chehih-Ramdani, Fatma. "La position américaine lors des conférences onusiennes sur les femmes : 1975-1995." Paris 3, 2008. http://www.theses.fr/2008PA030062.
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À partir des quatre conférences onusiennes sur les femmes organisées entre 1975 et 1995, cette thèse se propose d'analyser les relations entre les États-Unis et l'ONU sur les problèmes de population et de développement, plus particulièrement sur la question féminine. À l'interface de l'histoire intérieure et de la politique étrangère des États-Unis, notre sujet aborde une période décisive. Sur le plan intérieur, les années étudiées correspondent à l’affrontement entre, d’une part, un mouvement féministe galvanisé par le vote au Congrès de l’Equal Rights Amendment et par la légalisation de l’avortement, et, d’autre part, une droite chrétienne déterminée à imposer ses valeurs. En politique extérieure, le G77 parvient à défier la suprématie américaine et à installer son autorité politique dans l'arène internationale. C’est dans ce contexte que les organisations féministes utilisent l’ONU comme espace alternatif de revendications et réussissent progressivement à imposer leur agenda. En rendant compte de l'évolution du rôle des organisations féministes américaines dans l'élaboration du concept de santé reproductive, véritable épicentre du discours démographique dans les années 1990, notre analyse empirique donne un éclairage précis sur le processus interne de l’élaboration de la politique étrangère aux États-Unis, ainsi que dans sa dimension sociale. Elle démontre que le poids de la société civile dans la formulation du discours démographique est un nouveau paramètre des relations internationales de l'après-guerre froideUsing the four United Nations conferences organized between 1975 and 1995, the purpose of this dissertation is to analyse US and UN relations from a population and development perspective, and more specifically women’s issues. At the intersection of domestic policy and foreign policy, this study covers an interesting period. In the national arena, the time frame opposes the feminist movement and the Christian Right. The Equal Right Amendment vote by the Congress and the legalisation of abortion helped the feminist movement to change the social order and thus galvanized the Christian Right, making them determined to impose their values. In the international arena, the G77 new political authority challenged American supremacy. The feminist organizations then used the United Nations as an alternative claim arena and progressively succeeded in imposing their agenda. By focusing on the evolution of the specific role American feminist organizations played in the framing of the “reproductive right” concept at the core of the population discourse in the United Nations, this empirical study sheds some light on both American democracy at work at the United Nations and its broader social dimension. This new paradigm in the population discourse illustrates how civil society has become an important component in international policy framing
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Dantas, Suellen Maria Vieira. "Sexualidade, reprodução e relações de gênero: reflexões a partir da análise da politica nacional de saúde do homem." Universidade de São Paulo, 2017. http://www.teses.usp.br/teses/disponiveis/5/5137/tde-09082017-121622/.
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Estudos sobre a relação masculinidades-saúde tem apontando para a permanência de visões essencialistas sobre o sexo e desafios no que diz respeito aos direitos sexuais e reprodutivos, assim como para a dificuldade de se incluir homens nas práticas de cuidado em saúde devido às representações sociais do masculino e ao direcionamento dos serviços para mulheres e crianças. A implantação e implementação da \"Política Nacional de Atenção Integral à Saúde do Homem\" (PNAISH) no Brasil trouxe como desafio o reconhecimento das desigualdades de gênero vivenciadas pelos homens e de suas necessidades de saúde. Nesse sentido, compõe-se como justificativa para este trabalho a necessidade de se investigar como o homem tem sido contemplado institucionalmente em relação à sexualidade e reprodução. Assim, constitui-se como corpus da pesquisa o documento-base da política, documentos vinculados à construção da PNAISH e materiais desenvolvidos a partir desta, bem como publicações relacionadas à sexualidade e reprodução de homens nas páginas \"Saúde do Homem - Ministério da Saúde\" e \"Secretaria Municipal da Saúde de São Paulo\" em rede social. Por meio da análise de conteúdo, a discussão esteve amparada pelos pressupostos dos Estudos de Gênero e pelo pensamento foucaultiano. Buscou-se a compreensão de discursos que orientam a PNAISH: à que homens esta se dirige e como a política busca direcionar ações em saúde ao tratar da sexualidade e reprodução. Observou-se que a política reflete representações sociais, apresentando muitas das diferenças e desigualdades de gênero existentes. A sexualidade em seu sentido mais amplo é pouco abordada, observando-se ênfase dada à prática e potência sexual. Ainda, apesar de esforços, não houve plena incorporação de discursos de responsabilização igualitária nas questões reprodutivas e de parentalidade, estando ainda presentes visões sobre os homens como figuras de apoio. São necessárias ações que trabalhem as resistências a maiores liberdades e igualdades sexuais e reprodutivas? A PNAISH ainda precisa de maior aproximação das necessidades, diversidade de relações e desigualdades existentesStudies about the masculinity-health relationship have pointed to the persistence of essentialist visions about sex and challenges regarding sexual and reproductive rights, as well as the difficulty of including men in health care practices due to the social representations of the masculinity and the direction of the services for women and children. The implantation and implementation of the \"Brazilian Comprehensive Healthcare Policy for Men\" (PNAISH) in Brazil has brought as a challenge the recognition of the gender inequalities experienced by men and their health needs. In this sense, the justification for this study is the need to investigate how man has been contemplated in sexuality and reproduction institutionally. Thus, is constituted as corpus of the research, the official text of the policy, documents related to the construction of the PNAISH and materials developed from it, as well as publications related to sexuality and reproduction of men in the Facebook pages \"Health of Man - Ministry of Health\" and \"Municipal Health Department of São Paulo \". Through content analysis, the discussion was supported by the theories of Gender Studies and Foucaultian thinking. We sought the understanding of discourses that guide the PNAISH: to which men this is directed and how politics seeks to direct actions in health when dealing with sexuality and reproduction. It was observed that the policy reflects social representations, presenting many of the existing gender differences and inequalities. Sexuality in its broadest sense is not too much discussed in the documents, with an emphasis on sexual act and potency. Yet, despite efforts, there was no full incorporation of egalitarian accountability discourses on reproductive and parenting issues, and visions about men as support figures are still present. Still are needed actions that work the resistance for greater sexual and reproductive freedoms and for equality. The PNAISH still needs to approximate more to the needs, to the diversity of existing relationships and to the inequalities
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Johnson, Hazel Eileen. "Reproduction, exchange relations and food insecurity : maize production and maize markets in Honduras." Thesis, Open University, 1995. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.295260.
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Carvallo, Oscar R. "Values in the hidden curriculum : an axiological reproduction /." The Ohio State University, 1995. http://rave.ohiolink.edu/etdc/view?acc_num=osu1375117083.
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Yan, Che. "Reproduction within different population policy environments in rural China 1979-2000." Thesis, London School of Hygiene and Tropical Medicine (University of London), 2011. http://researchonline.lshtm.ac.uk/2242003/.
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This study uses data from National Family Planning and Reproductive Health Survey undertaken in 2001, systematic reviews of provincial policy fertility in 1990s, information on the nature of family planning (FP) services at grassroots institutions and a new measure of women's son preference, to advance knowledge of determinants of reproduction in rural China. The main statistical methods in this study include latent class analysis, life table, parity progression ratio, multilevel logistic regression and multilevel Poisson regression. The analysis is performed within groups of provinces according to their population policy (I-child, 1.5-child and 2-child). The results showed that fertility rate was closely related to China's population policy: the stricter the policy, the lower the fertility rate. By the end of the last century, fertility rates for the three types of provinces were close to respective policy fertility, indicating a success of China's population policy. However, strict population policy increased risks of abortion and imbalance in sex ratio at birth (SRB), particularly the rising sex ratio of second births in 1.5-child provinces. Variations in availability of specific FP methods by local services did not play a leading role in reducing fertility level, risk of abortion and imbalanced SRB. Son preference at province or individual level had strong impacts on progression to second birth, risk of abortion, and SRB, but the effects vary between types of provinces. Effects of other individual characteristics, i.e., couples' age, women's education, sex of existing child, on reproduction are also explored and discussed in this study. It can be concluded that strict implementation of population policy was the dominant influence on fertility levels but it also raised risk of abortion and imbalance in SRB in rural China. For these and other reasons, China needs to relax its I-child and 1.5-child policies immediately.
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Gautier, Frédéric. "Aux portes de la police : vocations et droits d'entrée : contribution à une sociologie des processus de reproduction des institutions." Thesis, Lille 2, 2015. http://www.theses.fr/2015LIL20013/document.
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Comment peut-on être policier ? C'est à cette question que tente de répondre cette thèse qui se propose d'analyser à la fois les processus de construction de l'attrait pour le métier de gardien de la paix et les modalités de la sélection des candidats. Elle s'intéresse d'abord aux droits d'entrée dont doivent s'acquitter les candidats. Bien que la nature et le « montant » de ces droits d'entrée fassent l'objet d'une définition officielle, le jugement des gatekeepersde l'institution est, en pratique, inapte à garantir la conformité des recrues auxexigences spécifiques du poste. En ce sens, les opérations de recrutement paraissent constituer un moment critique pour la stabilité de l'institution. Les processus qui conduisent à l'émergence et à la consolidation d'une vocation policière ont cependant pour effet de fabriquer des candidats biens disposés à l'égard de l'institution, prêts à se rendre compatibles. Ainsi, la police nationale constitue moins l'objet d'étude que le terrain d'investigation de cette thèse, qui propose une contribution à l'analyse des processus de reproduction des institutions engagées dans la mise en oeuvre de l'action publiqueHow can one be a police constable ? This thesis tries to answer this question by analysing the building process of attraction to police jobs and the procedures for selecting the candidates. It deals first with the entrance fee candidates must pay. Although the nature and the amount of this fee is officially defined, the sentence pronounced by the gate-keepers of the institution is, in fact, unable to ensure the compatility of the recruits with the requirements of the position. Recruitment actions can be seen, therefore, as a critical moment for the stability of the institution. However, the rise and consolidation of the vocation for police jobs make candidates socially prepared to comply with the institution.The police is more the inquiry field than the object of this thesis, that propounds a contribution to the analysis of the reproduction of institutions involved in public policy
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Lee, Pizzardi Olimpia. "Power to Choose?: An Analysis of the Implications of Gardasil for Immigrant Women." Oberlin College Honors Theses / OhioLINK, 2010. http://rave.ohiolink.edu/etdc/view?acc_num=oberlin1307129881.
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Baez-Olmeno, Maria Raquel. "Reproduction of cultural dependence into special education systems of Latin America with special reference to Chile." Thesis, Brunel University, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.310287.
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Yamamoto, Sergio Toshio. "Desencontros entre direitos e desejo da mulher e a decisão da equipe médica na prática da esterilização cirúrgica." Universidade de São Paulo, 2017. http://www.teses.usp.br/teses/disponiveis/6/6136/tde-15022018-154445/.
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Introdução - A esterilização cirúrgica é o método contraceptivo mais utilizado no mundo, com diferenças significativas entre países de alta renda e de média e baixa renda. Em nosso país, os últimos dados de 2006 (PNDS) revelaram que a prevalência da esterilização feminina era de 29 por cento e da pílula anticoncepcional, de 21 por cento , sendo a esterilização o método contraceptivo mais utilizado. A regulamentação da Lei 9263/96 inseriu a esterilização cirúrgica como um direito e em condições de igualdade de livre escolha dentre todos os outros métodos contraceptivos. Entretanto, as imprecisões presentes no texto da lei e as diferentes interpretações, por parte de profissionais, como de usuários, podem implicar em desencontros entre direitos e desejo da mulher e decisão da equipe médica. Conhecer o contexto social, conjugal e reprodutivo em que ocorrem esses desencontros e as implicações de diferentes naturezas apresenta-se como importante tema de pesquisa em saúde pública. Objetivos - Analisar os desencontros entre o desejo da mulher pela esterilização cirúrgica e motivos da discordância da equipe médica na tomada de decisão em relação aos critérios da Lei 9263/96. Metodologia - A pesquisa foi de natureza qualitativa, baseada na técnica de depoimento oral e roteiro do tipo temático, foram entrevistadas dez mulheres que optaram pela esterilização cirúrgica, as quais tiveram aconselhamento da equipe médica contrário ao seu desejo. Na interpretação das narrativas, foi utilizada uma aproximação da Análise de Discurso. Resultados - Todas as dez candidatas a esterilização cirúrgica encontravam-se gestantes e apresentavam características de risco aumentado ao arrependimento, notadamente pela flexibilidade à mudança da situação conjugal, tais como: idade menor que 25, parceiros muito jovens, primeiro filho do companheiro atual, baixa paridade, apenas um filho e pouco tempo de união. Nos discursos das mulheres, a esterilização cirúrgica requerida estava dentro dos critérios previstos na lei em relação à idade, ao número de filhos e no momento do parto - o que fica evidente em seus discursos é a de que o segundo filho, que ainda está no ventre, é contabilizado como filho vivo. Nos discursos dos médicos, a decisão contrária estava fundamentada na ilicitude ética e legal, prescritos na lei, principalmente em relação à idade, número de filhos vivos e, no momento do parto, no quesito duas cesáreas consecutivas anteriores. Caso exemplar para resolver este desencontro com a intervenção do Poder Judiciário é ilustrado neste estudo. Conclusão - A questão nuclear dos desencontros entre direitos e desejo da mulher e a decisão da equipe médica na prática da esterilização residem nas distintas interpretações do texto da lei 9263/96 entre os sujeitos: as mulheres, a equipe médica e o Poder Judiciário. Na prática da esterilização cirúrgica com a legislação vigente, resta para as conformadas a resignação e, para as indignadas, buscar o seu direito no Poder Judiciário. Às resignadas e aos profissionais de saúde, resta esperar pelo aperfeiçoamento da lei com texto mais preciso e claro que atenda as mulheres em seus direitos e desejo e que propicie aos profissionais de saúde uma prática isenta de conflitos morais, éticos e legais.Introduction - Surgical sterilization is the most used contraceptive method in the world with significant differences between high, medium and low incomes countries. In Brazil, data from 2006 (PNDS) revealed that female sterilization prevalence was 29 per cent , whereas the use of oral contraceptive was 21 per cent , making sterilization the most used contraceptive method in our country. The federal law 9263/96 introduced surgical sterilization as a legal right and with equal conditions to all other contraceptive methods. However, the inaccuracies present in the law text and in the different interpretations by professionals, as well as users, may produce in disagreements between womens rights/desires and the medical team decision. The social, marital and reproductive context in which these disagreements occur and the implications of diverse natures, present themselves as an important topic research in public health. Objectives - To analyze the divergences between the woman\'s desire for surgical sterilization and the reasons of the medical teams disagreement in relation to the criteria of law 9263/96. Methodology - The research was qualitative and based on the oral testimony and thematic script technique. It included the interview with ten women who opted for surgical sterilization and had counseling of the medical team contrary to their desire. Discourse Analysis were used in the narratives interpretation. Results - All ten candidates for surgical sterilization were pregnant and presented high risk of repentance, especially due to the flexibility of changing the marital situation, such as younger than 25 years, very young partners, first child of the current partner, few children, an only child and short time of union. In the women\'s speeches, the required surgical sterilization was within the criteria defined by the law as much as by age, number of children; it was evident in their speeches, is that the second child who is still in the womb is considered a living son. In the doctors\' speeches, the contrary decision was based on ethical and unlawfulness prescribed by law, especially in relation to age, number of living children and at the time of delivery, in the case of two previous consecutive cesarean section. An exemplary case to solve this disagreement with the judiciary intervention is illustrated in this study. Conclusion - The core issue of disagreement between women\'s rights and desires and the decision of the medical team in the sterilization practice lies in the different interpretations of the law 9263/96 by social subjects: women, medical team and the judiciary. In the surgical sterilization practice with the current legislation, remains the resignation to the conformed and outraged women to look for their rights in the Judiciary System. To the resigned and to the health professionals, it remains to wait for the law improvement with more precise and clear text, able to uphold the womens rights and desires and that it gives a practice free of moral, ethical and legal conflicts to the health professionals.