Rural Extension

1. Rural Extension Reproductive Health

2. Reproductive health care is defined as the constellation of methods, techniques and services that contribute to reproductive health and well-being through preventing and solving reproductive health problems..

3. It also includes sexual health, the purpose of which is the enhancement of life and personal relations, and not merely counseling and care related to reproduction and sexually transmitted diseases

4. Referral for family-planning services and further diagnosis and treatment for complications of pregnancy, delivery and abortion, infertility, reproductive tract infections, breast cancer and cancers of the reproductive system, sexually transmitted diseases and HIV/AIDS should always be available, as required

5. . Active discouragement of harmful practices such as female genital mutilation should also be an integral component of primary health care including reproductive health care programs.

6. Reproductive Health and MDGs ]. Indirectly, many reproductive health issues are part of the MDGs, e.g., reduction of child and maternal mortality and improved maternal health (goals number 4 and 5, respectively).

7. In addition, the promotion of gender equality and empowerment of women (goal 3) has a vital role. Adequate reproductive health services and family planning are essential. Combating HIV/AIDS, malaria, and other diseases (Goal 6),

8. Reproductive Health and Rural women Unlike most health care, reproductive health is a politically charged issue, especially in more conservative rural communities. Information about condoms and other birth control options can be hard to come by, especially if a person is young, embarrassed or doesn't know where to look..

9. Women bear their health problems in a “culture of silence” and do not seek timely health care. Along with this, there is often lack of information on good health practices, danger signals during pregnancy and the location of appropriate facilities. Strict seclusion norms prohibit women from visiting health facilities.

10. Quality reproductive health services and well-timed interventions are fundamental for achieving good maternal health, yet hundreds of thousands of women die each year because of a lack of such services.

11. In most developing regions, rural women have less access to skilled health personnel in delivery, even though the long-standing differences between rural and urban areas have declined in all regions and even been eliminated in a few

12. Problems facing the availability and accessibility of reproductive health care Lack of Strong Government commitment Socio-cultural barriers Lack of communication between urban centers and rural areas. Lack of adequate resources

13. Accessing health care in the public health clinics and hospitals is challenging for young rural women. Many are too far away from health facilities. Many health facilities are poorly resourced

14. Rural Women Have a More Limited Understanding Than Urban Women of How HIV Spreads, the First Step to Avoiding Infection .

15. Youth in rural areas, and especially young women, are even less likely to know about prevention methods or to use condoms than their urban counterparts

16. WHO data from 25 countries indicate that rural women are almost always less likely than urban women to report knowing about means of sexual transmission of HIV, in some cases by margins as large as 20-50 percent.

17. Reproductive and sexual health is a societal concern Reproductive and sexual health is a societal issue — not only the responsibility of the health sector. It is important to build partnerships with other public and private sectors, as well as with civil society. Effective health service delivery can be achieved by

18. Partnership with civil society Community involvement Inclusion health promotion activities Advocacy for reproductive health right Coordination across services, sectors, ministries

19. Role of community Communities can play an important role in building demand for appropriate reproductive health services. For instance, they can mobilize and build awareness at the local level about reproductive health issues..

20. They can collectively exert more pressure for public health service improvements than individuals. Such efforts can be especially effective and timely as health reform and decentralization is underway in many countries.

21. Innovative and participatory approaches are needed to ensure that reproductive health issues receive adequate attention during this transition.

22. UNFPA Key Tools/Activities Supporting the Empowerment of Rural Women UNFPA invests in highly successful methodologies for changing harmful social norms that exist largely in rural areas. This is done through working with expert civil society organizations that understand the specific context and who can influence communities on a wider scale.

23. UNFPA is also using integrated joint programmes and gender transformative programme design elements to increase sustainability.

24. Advocacy program for Youth Youth were, however, targeted for advocacy and information (including peer education program) Moreover, through advocacy and support for development of the National Adolescent Strategy, UNFPA has slowly but surely influenced the policy environment to accept that young peoples RH is an important issue.

25. The integration of Adolescents and Youth into the National Population and RH Strategy is seen as a major step forward. There is general acceptance that young people require RH information, but not universal acceptance that unmarried young people should be provided with RH services

26. Reproductive health Sudan Sudan is facing serious challenges in achieving the Millennium Development Goals (MDGs), particularly Goal no. 5. The levels of maternal and neonatal mortality in the country are unacceptably high.

27. Sudan's health sector is severely underfunded. One quarter of the population has no access to health facilities and only 19 per cent of the primary health care facilities provide the minimum health care package.

28. While 66 per cent of the functioning rural hospitals can now provide basic emergency obstetric and neonatal care, less than half of them provide comprehensive emergency obstetric and neonatal care services needed to save lives.

29. UNFPA Support Support is extended to improve service delivery through development of service delivery protocols and guidelines, conduct of operational research, surveys and studies and advocacy and community outreach. Reproductive health has become a standard part of emergency preparedness and response in humanitarian settings. .

30. Because of the geographic dispersal of underserved populations (rural and remote areas, IDPs camps and nomads), major support has been provided to training hundreds of Village Midwives for deployment in these areas; state level midwifery schools have been rehabilitated and equipped. In addition, a two-year Midwife Technician diploma and a four-year Bachelors of Science of Midwifery have been initiated to improve the availability of skilled birth attendants

31. health communication successful uses of health communication will utilize multifaceted approaches in order to best reach intended audiences with comprehensive interventions and messages that will ultimately protect public health outcomes.

32. Intended outcomes of health communication can include: increasing audience knowledge and awareness of a health issue; influencing behaviors and attitudes towards a health issue; demonstrating healthy practices; showing benefits of behavior changes to public health outcomes; advocating a position on a health issue or policy; increasing demand or support of health services; and arguing myths and misconceptions related to health.

33. A goal of effective health communication is to create higher levels of health literacy within a society, by using tools and methods of communication to promote healthy changes and lifestyle practices

34. Strategies and Methods Tailoring a health message is one strategy for persuasive health communication. [For messages of health communication to reach selected audiences accurately and quickly, health communication professionals must assemble a collection of superior and audience appropriate information that target population segments, as well as continually synthesize knowledge from a myriad of other scholarly disciplines including marketing, psychology, and behavioral sciences.

35. Once this information has been collected, professionals can choose from a variety of methods and strategies of communication that they believe would best convey their message. These methods include campaigns, entertainment advocacy, media advocacy, new technologies, and interpersonal communication.

36. Campaigns Health Communication campaigns are arguably the most utilized and effective method for spreading public health messages, especially in endorsing disease prevention (e.g. cancer, HIV/AIDS) and in general health promotion and wellness (e.g. family planning, reproductive health).[5] The Institute of Medicine argues that health communication campaigns tend to organize their message in relation to addressing a diverse audience in one of three ways:[4]

37. By catering to the common denominator within the audience By creating one central message and then later making systematic alterations in order to better reach a certain audience segment, while retaining the same central message By creating distinctly different messages for different audience segments

38. Media Advocacy Media Advocacy encompasses the utilization of strategic mass media tools combined with widespread organization in order to advocate for healthy public policies or lifestyles. This can include the use of Text Messaging and Email to spread messages from person to person, as well as using Social Networking sites such as Facebook, Twitter, and Instagram to promote health information to a wide ranging audience. As technologies expand, the platforms for health communication through media advocacy will undoubtedly expand as well.

39. New Technologies Health communication has grown significantly along with new computer-based interactive technologies that allow consumers to search for and access detailed and specific information, control how the information is presented to them, and ask and respond to questions at their own discretion.These technologies include online health and medical website and online support groups and chatrooms (e.g. Association for Cancer Online Resources).

40. One important aspect of this method of health communication is that it is extremely important in overcoming the barriers of low literacy, in that it creates a platform for personalized information easily accessed by people of all literacy and education levels and not overwhelmed with unexplained medical jargon.

41. Interpersonal Communication Health communication relies on strong interpersonal communications in order to influence health decisions and behaviors. The most important of these relationships are the connection and interaction between an individual and their medical provider (e.g. Physician, Therapist, Pharmacist) and an individual's social support system, which can include family, friends, or a general community that positively influence the individual's decision to make healthy choices.[

42. Mass Media Mass Communication is used to promote beneficial changes in behavior among members of populations.] A major criticism of the use of mass media as a method of health communication is the unfortunate ability for false and misinformed messages to spread quickly through the mass media, before they have the chance to be disputed by professionals.

43. This issue may generate unwarranted panic amongst those who receive the messages and be an issue as technology continues to advance. An example of this may be observed in the ongoing distrust of vaccinations due to the publication of numerous messages that wrongly link the childhood measles-mumps-rubella (MMR) vaccination with the development and onset of Autism.[

44. The speed with which this message spread due to new social networking technologies caused many parents to distrust vaccinations and therefore forgo having their children receive the vaccine. Although this panic has been ferociously labeled as fictitious, many still harbor a lingering suspicion towards vaccinations and refuse them, which has caused an immediate public health concern.