A Comprehensive Report on Sexual and Reproductive Health Intervention

This report focuses on sexual and reproductive health interventions among women in Goulburn North east Victoria, employing a socio-ecological approach. It examines the importance of access to services, identifies key determinants of health including economic, social, and behavioral factors, and assesses interventions against health promotion frameworks like the Ottawa Charter. The report emphasizes the need for equitable and inclusive services, violence-free environments, supportive settings, and access to abortion services, while also addressing social determinants and aligning with key determinants for the 21st century. It highlights the interconnectedness of these factors, advocating for policy changes, social shifts, and environmental considerations to improve women's health outcomes. The report also discusses the implementation of health promotion strategies, including enabling, mediating, and advocating, alongside the Commission on Social Determinants of Health principles, and emphasizes the role of political and social determinants in achieving successful interventions. It calls for continuous evaluation and education to ensure effective and widespread adoption of health messages.

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A Report on Sexual and Reproductive Health Intervention
By
Course
Professor
University
City
Date

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Introduction
Access to sexual and reproductive health services is a crucial and essential right for every
woman. However, there are usually some parts of this world where women have no access, have
little or no access to these services because of one reason or the other well-known to the health
care providers or the government. Good reproduction health is important for the general health of
both men and women. Majority of problems related to reproduction happen during the years of
reproduction which may bring lasting implications to health. Despite robust legislation in care
and treatment of women, they do not always have a timely access to pregnancy termination or
broader reproduction service needs. Additionally, there are a significant number of specific
health reproduction issues that affect the general health and wellness of women such as
endometriosis and polycystic ovarian syndrome together with ununderstood menopause that is
not managed as it is supposed to be. This report therefore aims to focus on sexual and
reproductive health intervention among women in Goulburn North east Victoria through use of
socio ecological approach, frameworks and approaches, evaluation of the systems thinking
approach and assessment of the intervention to whether it promotes equity in health.
Identification and Discussion of determinants of health
The population groups include the adolescents, young and the older women, women from
culturally and linguistically different backgrounds, people with disability and lastly women in
the similar sex relationships and gender diverse individuals. The social determinants of health are
the economic and social situations that contribute to individual and differences among groups in
health status (García-Moreno et al., 2015). Different heath interventions promote aspects or
factors in a population group. Because system thinking is a broad way of approaching problems
or issues by asking how different elements within a given system influence or affect another, it is

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an effective system to approach such existing problem. Instead of reacting to sexual reproduction
issues individually as they rise, system thinking tends to look for the underlying issues and
factors; the relationship between the existing problem or issues, over time look for patterns and
seek to find the root causes of the sexual reproduction among women (Svanemyr et al., 2015).
As the figure below demonstrates, it shows that just like an iceberg which has only the 10% of its
overall mass above the ocean whereas the largest percentage amounting to 90% is in the water
("systems thinking model: the iceberg," 2014). The largest percent is what the ocean waves acts
on every single time and the behavior of the ice berg is created by the ice tip because it is what
we can see.

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In the same way, the problems and the issues we observe in sexual and reproductive
among women is not just those problems, no. there is more than that, there is a beyond thing and
most people don’t recognize and understand. A causal man will approach such matters
superficially and will miss the point. There are myriad factors that are interconnected and
interrelated to make the huge problem that gives the sexual reproduction the behavior we see
(Miller et al., 2016). Most of the time we are unable to see the underlying conditions and
CONTRIBUT
ORY
obesity,
std,genital
infection,
substance
abuse
BEHAVIOURAL
SEXUAL EXPRESSION,SEXUAL PRACTICES, RELIGIOUS
BELIEFS AND PRACTICES, REPRODUCTIVE,
CONTRACEPTIVE PRACTICES,SEXUAL AND
REPRODUCTIVE LITERACY, ALCOHOL AND OTHER
DRUGS
SOCIO ECOLOGICAL DETERMINANTS
POPULATION: PUBLIC POLICY AND THE LAW, CULTURAL NORMS,
UN AFFORDABILITY TO HEALTH SERVICES,GENDER
INDIVIDUAL: POVERTY /SOCIO-ECONOMIC STATUS
VIOLENCE AND DISCRIMINATION

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structures that have contributed much to the major problem that is now visible. At the top most
of the ice berg we have the sexual and reproduction as a problem that is now visible and
identifiable but as you move down the iceberg inside the water you realize that there are other
factors that have in fact a large role in making the problem visible up there. Reproductive and
sexual and reproductive especially the STIs spread including HIV and pregnancies that are not
intended are largely influenced by economic, behavioral and social factors (Svanemyr et al.,
2015). Also, stigma is a major barrier and obstacle that prevents women from accessing the
services related to reproduction and health services. For stance the existing stigma around the
association of HIV and women who have once slept with a man can prevent and hinder them
from going for testing and knowing their status. The other underlying determinants are social
norms, educational attainment, location of women, insurance status, medical care and
dependency on alcohol and other drugs. When these determinants are addressed, there is an
assurance that there will be less problems experienced among women.
Assessing HP intervention against a Health Promotion Framework
The sexual and reproductive health intervention aims at focusing on access to safe and
inclusive services. Women are supposed to get timely sexual reproductive services and
additionally, should be affordable, inclusive and involving, culturally acceptable and safe. The
services should be provided without considering the woman’s gender identity, sexual orientation,
disability and a place of residence. In other words, the intervention should be aimed at providing
the services equitably and appropriately. The other intervention is living free from all forms of
violence (Lundgren et al., 2015). Women in their different living residential areas should live a
free life in communities that do not condone violence against women such as many forms of
sexual violence. The other intervention is fostering environments that are supportive. The sexual

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and reproductive health of women should be supported in all forms of environment not forgetting
at schools, work places and even the communities. The other intervention is facilitation of access
to abortion services. Women should have access to abortion services by first allowing the
government to pass a law that makes abortion legal (Lundgren et al., 2015). According to Salam
et al (2016), women opt for dangerous and risky abortion services so that they won’t be
identified otherwise if it abortion would have been made legal, they would be doing it the right
way: by going to hospital and be operated upon by a specialist and not quarks. Lundgren et al
(2015) also claims that allowing women to have safe abortions will eradicate the awkward
situations that we find our women over bleeding and doing because three was an attempted
abortion by the unprofessional people that did not come out successful. Finally, we have the
building of primary prevention. Women having all ability should access the sexual and
reproduction information and the general initiatives towards promotion of the wellbeing of a
woman sexually (Bean-Hodges & Reid, 2018).

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OTTAWA CHARTERO OTTAWA
CHARTER
The five key action areas in this health promotional intervention includes building public
policy that is healthy, creation of environments that are supportive, strengthening the action for
the community towards health, develop individual skills and finally reorganize the services for
health. Together with the three basic health promotion strategies the sexual health intervention is
directed to promoting health promotion which is also referred to as health education. the three
basic strategies include enabling, mediating and advocating (Haberland., 2015). They will all pay
a role together with the action plan to promote the desired health outcome among women. It is
thus evident that the interventions address actions on health across the health spectrum. Some of
gettingtimelysexualreprodictiveserviceswomenlivingfreefromallformsofviolencefosteringenvironmentsthataresupportiveprovidingaccesstosafeabortionservicesaccesstosafeandinclusiveservices.

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these actions include conducting research regarding women’s experience of stigma and
discrimination concerning STIs, promote services that will support and respect the rights of
women if they live, strengthening cooperation with service providers to enhance and improve the
support and access of these services. There is an interconnectedness between the health
promotion: the sexual reproduction health intervention with the health promotional framework.
Comparing Health Promotion (HP) intervention to the Commission on Social
Determinants of Health (WHO 2008); three principle areas of action
The sexual and reproduction intervention among women will improve the living
standards and enhance the daily life among not only women but also their young ones and the
generations to come. Tackling and mitigating the problems that the women are currently
undergoing would be number one step to improving the daily life of people including the women
themselves. Implementing the action plan would propagate knowledge and improve the level of
awareness hence initiatives are made stronger. The number two principle that will enable the
intervention to fit into is tackling the inequitable distribution of power, money and resources
(Brooks et al., 2019). Application of the Ottawa chatter will promote global, national and local
baseline reflection of how problems and issues affecting women can be solved and bring sanity
in the daily interaction and carrying out of women in the society. The intervention is aimed at
seeing to it that equitability in terms of power, resources and money distribution is achieved
among women (Petticrew, et al., 2019). This is to promote wellness and fairness that every
woman deserves just like any other women globally, regional and even locally. The last principle
comes in because after the interventions has been done and action plan has been affected, there
be need for evaluation to determine whether the strategies or rather intervention in place are
effective. It is out of the interventions developed that we will be able to organize and come up

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with a trained workforce that will provide education concerning the intended action plans so that
as the training and teaching of the action plan sets itself into being absorbed into people’s mind.
The earlier the educational message gets to people, the faster the objectives are achieved (Black
et al., 2016). As the trainers spread the health educational messages by face to face, through
giving out of brochures to educate and spread the message, it becomes relevant day by day. It
can also be done through relaying of the heath messages to media services and media sources
which are very good instruments for spreading messages within the shortest time possible and to
a wider coverage. Social determinants of health need to be addressed in a such a way that
everyone that needs to know and become aware of the determinants because knowledge is
power. Those who have knowledge are rich and that is why it is essential that the message gets to
them so that they will become rich and powerful and they would avoid any troubles they might
have been going through before.
Congruency with TWO of Kickbusch ‘s (2012) five key determinants of health for
21st Century
Political determinants of health play a major role in the sexual and reproduction health of
women. Political good will has a very big say in whether some of these interventions will
become successful or not. Availability of a woman voice in the parliament will foster change and
force things out because it is only women that understands themselves better (Duff et al., 2015).
Many women who are in the government fights for the fellow women for their rights and thus a
government that has some of the critical positions occupied by women will help propagate and
bring a faster implementation through faster provision of resources and funds required for the
appropriate actions to take place. Compared to the above determinant, social determinant of
health has a big role to play in the society. The change of attitude and mindset in the society

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especially by people of different gender since it would take time for them to change their mindset
that the women they used to know in the past as instruments of sex no longer the same. It will
also still take time for different group of people in the society to adapt the new changes in the
society for change to become effective (Dellar et al., 2015). Environmental determinants of
health also have a role to play in the sexual reproduction among women. Many women are
affected by the environment they live in and to some it happens out of ignorance. Similarly, the
environmental factors are also essential in intervention and action taking process. There should
be a cooperation and coordination among the implementers and the environmental factors. It is
important that such factors are also considered. Improving the conditions and likelihood of
occurrence of a problem in the environment is among the steps to succeed in implementation
process and bringing a desired outcome. Behavioral determinants of health would call for a
change of attitude and mindset among the women themselves. It is interesting to note that as
much as we want the common good for women, it could be that they are not ready for this
common good we are striving for them (Fogarty et al., 2015). It would turn out like we were
doing a ‘no’ job until sometimes later when we start seeing the fruits of the interception and
promotional activities. Otherwise in the beginning women would not readily accept the change
even if it will mean for their good.
Identification and discussion of systems thinking approaches informing the Health
Promotion intervention
There is an increasing interest in the probability of complex systems perspective in
processes of evaluation. In a way it is reflecting a linear move away from the initial interest in
the potentiality of causing a cause’ and effect’, that’s directed towards health considerations of
health as an outcome that that is originated from two interlinked elements (Walugembe., 2019).

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Even though approaches that are system based have a long history and indeed a big history, their
accurate effects on decision making affects different elements of given specificity. In the same
way, the implications of different perspectives of the systems for the carrying out systematic
reviews that requires advanced considerations are required. Such like reviews most of the time
underpin decisions concerning the implementation of the interventions that are effective
(Chandra-Mouli et al., 2015). Even though the system review is usually those that are tried and
tested as one of the means to synthesizing evidence on the wellness and effectiveness of
interventions, their use to the evidence synthesize about the complex systems and interventions.
It is therefore important to understand some time a system thinking may be complex and be in
congruency with the complex intervention. Complex intervention may be used to describe health
intervention for both the health service and the public health interventions not forgetting
educational and organizational interventions. The complex system can be different from complex
interventions. Even though they are all related at some point, they don’t eventually lead the same
part. They are directed to making the best out of what is available (Starrs et a., 2018). Fisher et
al school of thought concerning the system thinking is that it can be complex and at the same
time simple depending on the kind of intervention that is to be done or to be approached.
According to their way of thinking concerning the system thinking, it is evident that it has an
informed concept on the health promotion intervention.
Assessment of if and how the HP intervention promotes health equity and/or action on
environmental sustainability
It is very evident that the health intervention will promote health equity and a positive
action on sustainability of the environment. Health equity will be achieved because the main
reason why we need to fight for the rights of women and bring effective mechanism in place for

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their sake is because we want to promote equity among the woman with other women from other
regions (Casey, 2015). Health equity means the absence of avoidable, remediable and unfair in
differences among the groups of people regardless of whether the subject matter is defined by
social, economic demographic and locational ("Health equity," n.d.). Health equity is in other
words referred to as equity in health. In other words, no one should be disadvantaged to getting
the services that he/she is supposed to get. Because there has been denial of the very fundamental
rights of women in north east Victoria and Goulburn, there is great a need that they are restored
or enacted. Women who have been for a long time been denied their fundamental rights will
once again have them so that they get what rightfully belongs to them (Wamoyi, Wight and
Remes, 2015). It is of no doubt that many people are in a state of confusion seeking to
understand and know whether it is all enough to state that there will ever be anything like
equality in health. Truth of the facts is that even though there might not exist equality in health
but at least seeking an intervention marks the beginning of bringing back rather restoring the
health equity that might have been for a long time missing in a certain society, country or region.
It is undoubted that after the sexual reproduction intervention is achieved and health equity
among women will be restored (Temmerman, Khosla, Bhutta, and Bustreo, 2015).
Environmental sustainability refers to the rate by which resources that are renewable can be
harvested, creation of pollution, and non-renewable resources exhaustion that can be indefinitely
continued. If the resources cannot be indefinitely continued then it means that they are
unsustainable. The concept of sustainability especially in most public health interventions is
confusing because of variations in the terminology and non-existence of measurement that is
agreed frameworks, and similarly as the methodological issues (Tannenbaum, Greaves and
Graham, 2016). Nevertheless, the most important fact to understand is that beneficial

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intervention such as this: sexual reproduction needs to be supported by sustainability so that
resources that are limited are utilized maximumly and long term public health are realized.
Conclusion
In conclusion, it is evident that sexual reproduction intervention as a form of health
promotion intervention is a necessity that needs to be implemented to bring changes in the
system. It is evident from what is discussed above that it is worth bringing an intervention: one,
sexual reproduction health intervention can be mapped together with the causal chain factors
using the socio ecological determinants approach; the relationship then can be represented in ice
berg model. Two, it is possible to access the efficacy of the health intervention in relating to
Ottawa charter and the fact that it addresses actions on health across the health spectrum, it also
fits into three principal areas of action as identified by CSDH WHO 2008, there is some
congruency between the health intervention and determinants of health and finally it promotes
health intervention for the health issue and among the population group of concern. sexual
reproduction issues are real and complex to an extent that they have had detrimental effects to
women. It is therefore with utmost joy that I believe that the intervention can and will bring the
effective change that might have been long desired for. It is undoubted that the heath intervention
system has all it takes to bring health equity. Therefore, I can confidently recommend to world
health organization this health intervention that relates my health issue of concern since it is
appropriate for the 21st century. It is to my best knowledge the appropriate and relevant health
promotional intervention that can be adopted to bring about effective desired change. Interesting
enough it ca be adopted by WHO and become the global baseline health promotional
intervention and become effective, impactful and life changing intervention in regions where
reproduction and sexuality among women have been troublesome.

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References
A Systems Thinking Model: the iceberg. (2014, April 11). Retrieved from
https://nwei.org/iceberg/
Bean-Hodges, A., & Reid, A. 2018. Sexual health service at the Royal women's hospital,
Melbourne. Australian Nursing and Midwifery Journal, 25(9), 47.
Black, R.E., Levin, C., Walker, N., Chou, D., Liu, L., Temmerman, M. and Group, D.R.A.,
2016. Reproductive, maternal, newborn, and child health: key messages from Disease
Control Priorities 3rd Edition. The Lancet, 388(10061), pp.2811-2824.
Brooks, M. I., Johns, N. E., Quinn, A. K., Boyce, S. C., Fatouma, I. A., Oumarou, A. O., ... &
Silverman, J. G. 2019. Can community health workers increase modern contraceptive
use among young married women? A cross-sectional study in rural
Niger. Reproductive health, 16(1), 38.
Casey, S.E., 2015. Evaluations of reproductive health programs in humanitarian settings: a
systematic review. Conflict and health, 9(1), p.S1.
Chandra-Mouli, V., Svanemyr, J., Amin, A., Fogstad, H., Say, L., Girard, F. and Temmerman,
M., 2015. Twenty years after International Conference on Population and
Development: where are we with adolescent sexual and reproductive health and
rights?. Journal of Adolescent Health, 56(1), pp.S1-S6.

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Dellar, R.C., Dlamini, S. and Karim, Q.A., 2015. Adolescent girls and young women: key
populations for HIV epidemic control. Journal of the International AIDS Society, 18,
p.19408.
Duff, P., Shoveller, J., Dobrer, S., Ogilvie, G., Montaner, J., Chettiar, J. and Shannon, K., 2015.
The relationship between social, policy and physical venue features and social cohesion
on condom use for pregnancy prevention among sex workers: a safer indoor work
environment scale. J Epidemiol Community Health, 69(7), pp.666-672.
Fogarty, L.A., Heilig, C.M., Armstrong, K., Cabral, R., Galavotti, C., Gielen, A.C. and Green,
B.M., 2016. Long-term effectiveness of a peer-based intervention to promote condom
and contraceptive use among HIV-positive and at-risk women. Public health reports.
García-Moreno, C., Hegarty, K., d'Oliveira, A.F.L., Koziol-McLain, J., Colombini, M. and
Feder, G., 2015. The health-systems response to violence against women. The
Lancet, 385(9977), pp.1567-1579.
Haberland, N. and Rogow, D., 2015. Sexuality education: emerging trends in evidence and
practice. Journal of adolescent health, 56(1), pp.S15-S21.
Health equity. (n.d.). Retrieved from https://www.who.int/topics/health_equity/en/
Lundgren, R. and Amin, A., 2015. Addressing intimate partner violence and sexual violence
among adolescents: emerging evidence of effectiveness. Journal of Adolescent
Health, 56(1), pp.S42-S50.
Miller, E., Tancredi, D.J., Decker, M.R., McCauley, H.L., Jones, K.A., Anderson, H., James, L.
and Silverman, J.G., 2016. A family planning clinic-based intervention to address

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reproductive coercion: a cluster randomized controlled trial. Contraception, 94(1),
pp.58-67.
Petticrew, M., Knai, C., Thomas, J., Rehfuess, E.A., Noyes, J., Gerhardus, A., Grimshaw, J.M.,
Rutter, H. and McGill, E., 2019. Implications of a complexity perspective for
systematic reviews and guideline development in health decision making. BMJ global
health, 4(Suppl 1), p.e000899.
Salam, R.A., Faqqah, A., Sajjad, N., Lassi, Z.S., Das, J.K., Kaufman, M. and Bhutta, Z.A., 2016.
Improving adolescent sexual and reproductive health: A systematic review of potential
interventions. Journal of adolescent health, 59(4), pp.S11-S28.
Starrs, A.M., Ezeh, A.C., Barker, G., Basu, A., Bertrand, J.T., Blum, R., Coll-Seck, A.M.,
Grover, A., Laski, L., Roa, M. and Sathar, Z.A., 2018. Accelerate progress—sexual
and reproductive health and rights for all: report of the Guttmacher–Lancet
Commission. The Lancet, 391(10140), pp.2642-2692.
Svanemyr, J., Amin, A., Robles, O.J. and Greene, M.E., 2015. Creating an enabling environment
for adolescent sexual and reproductive health: a framework and promising
approaches. Journal of adolescent health, 56(1), pp.S7-S14.
Tannenbaum, C., Greaves, L. and Graham, I.D., 2016. Why sex and gender matter in
implementation research. BMC medical research methodology, 16(1), p.145.
Temmerman, M., Khosla, R., Bhutta, Z.A. and Bustreo, F., 2015. Towards a new global strategy
for women’s, children’s and adolescents’ health. bmj, 351, p.h4414.

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Walugembe, D.R., Sibbald, S., Le Ber, M.J. and Kothari, A., 2019. Sustainability of public
health interventions: where are the gaps? Health research policy and systems, 17(1),
p.8.
Wamoyi, J., Wight, D. and Remes, P., 2015. The structural influence of family and parenting on
young people's sexual and reproductive health in rural northern Tanzania. Culture,
health & sexuality, 17(6), pp.718-732.