Abortion

An abortion can occur either spontaneously, when it is called a spontaneous abortion or miscarriage, or it can be brought about by deliberate intervention, when it is called an induced abortion. The stage at which a fetus is considered viable varies according to different legislations and recommendations.

Abortion rate

The number of abortions taking place among women of reproductive age (usually 15-49), over a given period, usually a year, expressed per 1,000 women.

Abortion ratio

The number of abortions to the number of live births over a given period, described per 100 live births in a given year.

Abstinence

Abstinence is a conscious decision to avoid certain activities or behaviours. Different people have different definitions of sexual abstinence. For some, it may mean no sexual contact. For others, it may mean no penetration (oral, anal, vaginal) or only 'lower-risk' behaviours.

Abstinence-only education

Education which promotes abstinence from all forms of sexual activity until marriage, and abstinence as the only way in which HIV infections and unwanted pregnancies can be prevented.

This type of education does not discuss issues relating to contraception, sexuality or sexual and reproductive health issues which are included in comprehensive sexuality education programmes. (See also Sexuality Education).

It should be noted that abstinence is often taught as one option for safer sex in comprehensive sexuality education programmes.

Acquired immunodeficiency syndrome

The late stage of infection caused by the Human Immunodeficiency Virus (HIV). HIV steadily weakens the body's defence (immune) system until it can no longer fight off life-threatening illnesses. These include infections such as pneumonia and certain cancers.

Adolescence

The World Health Organization uses the 10-19 year age range to define adolescence.

Advocacy

A campaign or strategy to build support for a cause or issue. Advocacy is directed towards creating a favourable environment, by trying to gain people's support and by trying to influence or change legislation.

Age-sex structure

The composition of a population according to the number or proportion of males and females in each age group.

Age-specific fertility rate

The number of births occurring during a given year or reference period per 1,000 women of reproductive age classified in single- or five-year age groups.

AIDS

Acquired immunodeficiency syndrome. The late stage of infection caused by the Human Immunodeficiency Virus (HIV). HIV steadily weakens the body's defence (immune) system until it can no longer fight off life-threatening illnesses. These include infections such as pneumonia and certain cancers.

Amniocentesis

The extraction of the fluid surrounding the fetus inside the membrane for pre-natal diagnosis.

Antiprogestagens

Compounds that block the action of the hormone progesterone. Since progesterone is essential for the maintenance of pregnancy, antiprogestagens were first developed for the medical termination of pregnancy. The first to be widely used was mifepristone, popularly known as RU-486.

Antiretroviral therapy

Antiretroviral therapy is the course of medications or drugs you take to fight HIV. Other terms that mean the same thing are 'anti-retroviral drugs', 'HIV treatment', 'medications', 'drug regimen' and 'HIV drugs'.

ART

Antiretroviral therapy is the course of medications or drugs you take to fight HIV. Other terms that mean the same thing are HAART (Highly Active Antiretroviral Therapy), 'antiretroviral drugs', 'HIV treatment', 'medications', 'drug regimen' and 'HIV drugs'.

ARVs

Antiretrovirals - Antiretroviral therapy is the course of medications or drugs you take to fight HIV. Other terms that mean the same thing are HAART (Highly Active Antiretroviral Therapy), 'anti-retroviral drugs', 'HIV treatment', 'medications', 'drug regimen' and 'HIV drugs'.

Barrier methods

Barrier methods of contraception prevent pregnancy by physically or chemically blocking the entrance of sperm into the uterine cavity. Some, particularly condoms, help to protect against sexually transmitted infections, including HIV infection. Barrier methods include cervical caps, condoms, diaphragms, female condoms, spermicides and sponges.

Basal body temperature

The body’s core temperature.

Baseline survey

A survey that is conducted at the start of a project to determine the level of key indicators against which future results are compared.

Benchmarking

A technique in which a set of indicators (benchmarks) are established, against which performance or progress towards objectives can be measured.

Billings method

Also known as the Ovulation Method - see Periodic Abstinence

Birth control

The term used in the early days of modern family planning. It refers to all methods of preventing births, including abstinence and abortion.

Birth rate

The number of live births per 1,000 population in a given year. Also called crude birth rate.

Births averted

A measure of the number of births which have not occurred because of the effects of a family planning programme. It involves a number of assumptions about several aspects of the reproductive process and is not a precise figure.

Calendar method

This method uses records of previous menstrual cycles to predict the fertile period. Also known as the rhythm method.

CBCT

Community-based clinical trial. A clinical trial conducted primarily through primary-care physicians rather than academic research facilities.

CBD

Community-based distribution. An approach to delivering family planning and sexual and reproductive health services which does not require a clinic setting. Individuals who live in and are members of the community are trained to provide health education, advice and supplies, and to make referrals. A CBD worker educates people in their own community, motivates them, distributes contraceptives, refers clients to health facilities, and possibly provides other sexual and reproductive health services.

CBR

Crude birth rate. The number of live births per 1,000 population in a given year.

Child mortality rate

The number of deaths of children aged 1-4 years per 1,000 children in that age group over a period of a year. This measure excludes deaths of infants (i.e. children aged less than one year) so an alternative indicator, the under-five mortality rate, is sometimes used which includes infant deaths.

Childbearing years

Reproductive age. The span of ages at which individuals are capable of becoming parents. The phrase can be applied to men and women but most frequently refers to women. 'Couples in reproductive ages' nearly always means couples where the woman is of childbearing age. The age range 15-49 years is most often taken, but occasionally 15-44 is used, including in the United States.

Client flow analysis

The process of determining the efficiency of service delivery operations in a health facility. It is based on observations made of the movement of clients through the health facility and tracks, in particular, the amount of time a client spends waiting to be seen by a provider and the amount of contact time a client has with each of the clinic's service providers. Also known as patient flow analysis.

Client profile

A representation in numbers and/or percentages of the main characteristics of a programme's clients. A client profile allows managers to gain a better understanding of the types of clients the programme serves and, in some cases, the high-priority needs of those clients, so that the programme can better serve its clients and potentially attract new clients who have similar needs.

Client satisfaction

The benefits or the value of the services (as perceived by the clients) provided by a programme or clinic, often measured in terms of the quality of interaction with providers, the range of contraceptive choice, and the efficiency and responsiveness to individual client needs.

Clinical trial

A scientifically designed and executed investigation of the effects of an intervention (drug, vaccine, biologic or behavioural) administered to people.

Clitoridectomy

Female genital cutting. A traditional practice that involves cutting away parts of the female external genitalia, or other injury to the female genitals, for cultural or other non-therapeutic reasons, rendering intercourse and childbirth painful and potentially hazardous. It is usually carried out by traditional practitioners under unhygienic conditions. Also referred to as female genital mutilation or female circumcision.

The World Health Organization has classified female genital cutting into four main groupings:

Type I clitoridectomy involves the removal of the prepuce (clitoral hood), sometimes together with part or all of the clitoris. This is what is commonly referred to as 'Sunna circumcision'.

Type II involves excision, where both the clitoris and part or all of the labia minora (inner vaginal lips) are removed.

Type III (infibulation) is where the clitoris is removed, some or all of the labia minora are amputated and incisions are made on the labia majora (outer lips) to create a raw surface. These raw surfaces are either stitched together and/or kept in contact until they seal as a 'hood of skin' covering the urethra and most of the vaginal opening. A small opening is created to allow the flow of urine and menstrual blood.

Type IV is an unclassified category that includes other operations on the external genitalia including introcision, piercing or incising the clitoris and/or labia, cauterization, scraping and/or cutting of the vagina, introduction of corrosive substances and herbs into the vagina and similar practices.

COC

Combined oral contraceptive. See Hormonal Contraception

Coitus interruptus

'Withdrawal method'. Also known as coitus interruptus. Not a proper method of contraception.

Combined oral contraceptive

Hormonal contraception. Systemic methods of contraception based on either a progestagen combined with an oestrogen or a progestagen alone. The methods of delivery include pills (oral contraceptives), injectables and implants. All are reversible.

Pills (two types):

Combined oral contraceptives (COCs) contain synthetic oestrogen and progestagen. They can be monophasic, i.e. a fixed concentration of hormones throughout 21 days of the 28-day menstrual cycle, or multiphasic, with two (biphasic) or three (triphasic) variations of concentration throughout the cycle.

Progestagen-only pills (POPs) contain only a progestagen, in a smaller dose than in COCs.

Injectables are longer lasting than oral contraceptives. The first were composed of progestagen only, the most common being depot medroxyprogesterone acetate, or DMPA, which lasts three months, and norethisterone oenanthate, or NET-EN, which lasts two months. The newer monthly injectables contain both oestrogen and progestagen.

Subdermal implants are even longer acting (approximately five years) and contain low doses of progestagen. Six thin silicone rubber capsules are inserted subdermally in the woman's arm by a minor surgical procedure under local anaesthesia. The implants may be removed at any time.

Community-based clinical trial

A clinical trial conducted mainly through primary-care physicians rather than academic research facilities.

Community-based distribution

An approach to delivering family planning and sexual and reproductive health services which does not require a clinic setting. Individuals who live in and are members of the community are trained to provide health education, advice and supplies, and to make referrals. A CBD worker educates people in their own community, motivates them, distributes contraceptives, refers clients to health facilities, and possibly provides other sexual and reproductive health services.

Community-based services

Sexual and reproductive health information and services provided to women, men and young people where they live using specially trained members of the community (community-based volunteers), who provide selected contraceptive methods, sexual and reproductive health information and refer clients to clinics when appropriate.

Comprehensive sexuality education

Education about all matters relating to sexuality and its expression. Comprehensive sexuality education covers the same topics as sex education but also includes issues such as relationships, attitudes towards sexuality, sexual roles, gender relations and the social pressures to be sexually active, and it provides information about sexual and reproductive health services. It may also include training in communication and decision-making skills.

Continuation rate

The number of users who continue to use any method of contraception, measured among a designated population (community, district, programme area), covering a specific period of time (month, quarter, or year). A continuation rate can also be measured for one specific method.

Contraceptive effectiveness

The extent to which a contraceptive method reduces the chance of conception.

Theoretical effectiveness, or perfect use, refers to the efficacy of the method in laboratory conditions.

Use effectiveness, or typical use is a measure of practical protection, taking into account failure to use the method correctly.

The Pearl Index relates the number of contraceptive failures (unintended pregnancies) to the number of months of exposure to risk, and is expressed per 100 woman-years. A more sophisticated approach is to use life-table analyses.

Contraceptive prevalence rate

The percentage of all women of reproductive age or married women of reproductive age, typically aged 15-49, who are using a method of contraception.

Couple-years of protection

A measure representing the total number of years of contraceptive protection provided by a method, for one couple, for one year.

CPR

The percentage of all women of reproductive age or married women of reproductive age, typically aged 15-49, who are using a method of contraception.

Crude birth rate

The number of live births per 1,000 population in a given year.

CYP

Couple-years of protection. A measure representing the total number of years of contraceptive protection provided by a method, for one couple, for one year.

Demographic and health surveys

A programme of national surveys on fertility, family planning, maternal and child health and household living conditions. The DHS began in 1984, funded by the US Agency for International Development (USAID), and represents one of the largest sources of information on the reproductive and health behaviour of women.

Demographic momentum

The increase in population size which would still occur if the fertility of a population changed immediately to a level which would just ensure the replacement of each generation. Shows the effect of age structure on growth rates.

Demographic transition

The shift from high levels of fertility and mortality in a population to low levels.

Dependency ratio

The ratio of the economically dependent part of the population to the productive part. The ages chosen are arbitrary, but the working population is usually taken as those people aged between 15 and 64 years. The ratio is thus the number of people below 15 or above 64 years of age, divided by the number in the working ages. This often does not reflect the working structure in developing countries.

Depot medroxyprogesterone acetate

Hormonal contraception. Systemic methods of contraception based on either a progestagen combined with an oestrogen or a progestagen alone. The methods of delivery include pills (oral contraceptives), injectables and implants. All are reversible.

Pills (two types):

Combined oral contraceptives (COCs) contain synthetic oestrogen and progestagen. They can be monophasic, i.e. a fixed concentration of hormones throughout 21 days of the 28-day menstrual cycle, or multiphasic, with two (biphasic) or three (triphasic) variations of concentration throughout the cycle.

Progestagen-only pills (POPs) contain only a progestagen, in a smaller dose than in COCs.

Injectables are longer lasting than oral contraceptives. The first were composed of progestagen only, the most common being depot medroxyprogesterone acetate, or DMPA, which lasts three months, and norethisterone oenanthate, or NET-EN, which lasts two months. The newer monthly injectables contain both oestrogen and progestagen.

Subdermal implants are even longer acting (approximately five years) and contain low doses of progestagen. Six thin silicone rubber capsules are inserted subdermally in the woman's arm by a minor surgical procedure under local anaesthesia. The implants may be removed at any time.

DHS

Demographic and health surveys. A programme of national surveys on fertility, family planning, maternal and child health and household living conditions. The DHS began in 1984, funded by the US Agency for International Development (USAID), and represents one of the largest sources of information on the reproductive and health behaviour of women.

DMPA

Depot medroxyprogesterone acetate. Hormonal Contraception: systemic methods of contraception based on either a progestagen combined with an oestrogen or a progestagen alone. The methods of delivery include pills (oral contraceptives), injectables and implants. All are reversible.

Doubling time

The number of years required for a specified population to double its size at the current rate of population growth. It is used as an easy and vivid way of depicting the implications of a particular rate of growth.

Drug resistance

The ability of some disease-causing micro-organisms, such as bacteria, viruses, and mycoplasma, to adapt themselves, to grow, and to multiply even in the presence of drugs that usually kill them.

Dual protection

Dual protection is protection against both unintended pregnancy and sexually transmitted infections, including HIV. For sexually active individuals, a condom is the only device that is effective for dual protection. Dual protection can also be achieved by using condoms with another method of contraception, referred to as dual method or double protection.

EC

Emergency contraception. A method of contraception used to avoid pregnancy after a single act of sexual intercourse that was unprotected due to lack of use or failure of a contraceptive. Two types are available:

Hormonal treatment with high-dose oestrogen, a low-dose oestrogen-progestagen combination or progestagen alone. Emergency Contraception Pills (ECPs) should be taken as soon as possible after unprotected sex.

The insertion of an intra-uterine device, which has to be carried out within five days of unprotected sex.

Emergency contraception pills (ECPs) are thought to prevent ovulation, fertilization, and/or implantation. ECPs are not effective once the process of implantation has begun, and will not cause abortion.

Recent studies have provided new information concerning the regimen for levonorgestrel-only and Yuzpe ECPs. This research indicates that ECPs can prevent pregnancy up to five days (120 hours) after unprotected intercourse.

Embryo

The fertilized egg up to eight weeks after implantation.

Emergency contraception

Method of contraception used to avoid pregnancy after a single act of sexual intercourse that was unprotected due to lack of use or failure of a contraceptive. Emergency contraceptive pills (ECPs) are thought to prevent ovulation, fertilization, and/or implantation. ECPs are not effective once the process of implantation has begun, and do not cause abortion.

Emergency obstetric care

Basic care includes parenteral antibiotics, oxytocic and sedatives; manual removal of the placenta; manual removal of retained products of conception; and assisted (vaginal) delivery. Comprehensive district level care would also include obstetric surgery and blood transfusions.

Empowerment

The ability, or the process of developing the ability, to achieve one's full potential in society and shape one's life according to one's own aspirations. The process of empowerment involves changing existing power relations and the forces that marginalize women and other disadvantaged sections of society.

EOC

Emergency obstetric care. Basic care includes parenteral antibiotics, oxytocic and sedatives; manual removal of the placenta; manual removal of retained products of conception; and assisted (vaginal) delivery. Comprehensive district level care also includes obstetric surgery and blood transfusions.

ESEAOR

East & South East Asia and Oceania Region

Family life education

An educational process designed to assist young people in their physical, social, emotional and moral development as they prepare for adulthood, marriage, parenthood, and ageing, as well as their social relationships in the socio-cultural context of family and society. FLE programmes have often been integrated into geography, biology, home economics and religious or moral studies curricula. They have also tended to emphasize traditional values and the family, and exclude sexuality, in order to avoid political or religious opposition.

Fecundability

The probability of conception in one menstrual cycle among women who menstruate regularly but do not use contraception.

Fecundity

The physiological capacity of a woman or man to produce or beget a live child. See also fertility, which is actual reproductive performance.

Female circumcision

See Female genital cutting. A traditional practice that involves cutting away parts of the female external genitalia, or other injury to the female genitals, for cultural or other non-therapeutic reasons, rendering intercourse and childbirth painful and potentially hazardous. It is usually carried out by traditional practitioners under unhygienic conditions.

Female genital cutting

A traditional practice that involves cutting away parts of the female external genitalia, or other injury to the female genitals, for cultural or other non-therapeutic reasons, rendering intercourse and childbirth painful and potentially hazardous. It is usually carried out by traditional practitioners under unhygienic conditions. Also referred to as female genital mutilation or female circumcision. The World Health Organization has classified female genital cutting into four main groupings, Types I to IV, based on the degree of damage inflicted.

Female genital mutilation

Female genital cutting. A traditional practice that involves cutting away parts of the female external genitalia, or other injury to the female genitals, for cultural or other non-therapeutic reasons, rendering intercourse and childbirth painful and potentially hazardous. It is usually carried out by traditional practitioners under unhygienic conditions. Also referred to as female genital mutilation or female circumcision.

The World Health Organization has classified female genital cutting into four main groupings:

Type I clitoridectomy involves the removal of the prepuce (clitoral hood), sometimes together with part or all of the clitoris. This is what is commonly referred to as 'Sunna circumcision'.

Type II involves excision, where both the clitoris and part or all of the labia minora (inner vaginal lips) are removed.

Type III (infibulation) is where the clitoris is removed, some or all of the labia minora are amputated and incisions are made on the labia majora (outer lips) to create a raw surface. These raw surfaces are either stitched together and/or kept in contact until they seal as a 'hood of skin' covering the urethra and most of the vaginal opening. A small opening is created to allow the flow of urine and menstrual blood.

Type IV is an unclassified category that includes other operations on the external genitalia including introcision, piercing or incising the clitoris and/or labia, cauterization, scraping and/or cutting of the vagina, introduction of corrosive substances and herbs into the vagina and similar practices.

Fertility

The actual reproductive performance of an individual, group or society.

Fertility awareness

Periodic abstinence. A method of contraception in which couples avoid sexual intercourse during the fertile phase of the menstrual cycle. This method depends on the ability of the couple to identify the fertile phase (sometimes called fertility awareness), and the couple's motivation and discipline to practise abstinence when required. There are a number of techniques for detecting the fertile period:

The basal body temperature (BBT) method is based on the increase in body temperature that occurs shortly after ovulation, associated with secretion of progesterone. After ovulation the body temperature rises and remains high until the next menstruation. The couple are advised to refrain from sexual intercourse between the first day of menstruation and the third consecutive day of elevated temperature.

The cervical mucus or ovulation method (also known as the Billings method) relies on recognizing and interpreting cyclic changes in cervical mucus that occur in response to changing oestrogen levels. During a menstrual cycle a woman may experience different sensations at the opening of the vagina and changes in the characteristics of the cervical mucus. Couples practising this technique can have sexual intercourse during both pre- and post-ovulatory phases as it is possible to identify the infertile phase in both parts of the cycle by monitoring the mucus pattern.

The calendar or rhythm method uses records of previous menstrual cycles to predict the fertile period. The first fertile day is calculated by subtracting 18 days from the first day of menstruation of the shortest menstrual cycle; the last fertile day is calculated by subtracting 11 days from the longest cycle.

The sympto-thermal method (STM) combines various periodic abstinence techniques, especially cervical mucus changes, the calendar method and BBT. The use of multiple techniques is more accurate than a single technique for identifying the fertile phase of the menstrual cycle, while the days of required abstinence can be kept to a minimum.

All these methods of detecting the fertile phase are also helpful for couples who wish to use barrier methods on those days estimated to be fertile, and for couples who are trying to improve their chances of conception.

Fertility rates

Measures which relate the number of births in a given period to the number of women of reproductive age (unlike the crude birth rate, which relates births to the whole population). The general fertility rate relates births in a particular period, usually a year, to women aged 15-49 or 15-44 years at that time.

Fertility regulation

The process by which individuals and couples regulate their fertility. Methods include, among others, delaying childbearing, using contraception, seeking treatment for infertility, interrupting unwanted pregnancies and so on.

Fetus

A fertilized egg implanted in the womb that has grown beyond eight weeks.

FGM

Stands for Female Genital Mutilation. See Female Genital Cutting.

Fistula

Obstetric fistulae. A rupture that results in an abnormal passage linking two areas such as the vagina, rectum, bladder, and abdominal cavity. Obstetric fistulae are caused by difficult labour, unsafe abortion, and traditional practices such as female genital cutting.

FP

Family planning. The conscious effort of couples or individuals to plan for and attain their desired number of children and to regulate the spacing and timing of their births. Family planning is achieved through contraception and through the treatment of involuntary infertility.

GBV

Gender-based violence. The United Nations General Assembly in 1993 adopted the definition of violence against women as "any act that results in, or is likely to result in, physical, sexual, or psychological harm or suffering to women, including threats of such acts, coercion or arbitrary deprivation of liberty, whether occurring in public or private life. It encompasses, but is not limited to: physical, sexual and psychological violence occurring in the family, including battering, sexual abuse of female children in the household, dowry-related violence, marital rape, female genital cutting and other traditional practices harmful to women, non-spousal violence and violence related to exploitation; physical, sexual and psychological violence occurring within the general community, including rape, sexual abuse, sexual harassment and intimidation at work, in educational institutions and elsewhere; trafficking in women and forced prostitution; and physical, sexual and psychological violence perpetrated or condoned by the state, wherever it occurs."

Gender

Gender refers to the economic, social and cultural attributes and opportunities associated with being male or female in a particular point in time. (World Health Organization definition).

Gender equality

Measurable equal representation of women and men. Gender equality does not imply that women and men are the same, but that they have equal value and should be accorded equal treatment.

Gender equity

The application of fairness or justice in all gender issues. This applies both to the composition of power structures and to social divisions of labour.

Gender mainstreaming

A new term that is similar to gender perspective or gender sensitive focus. It is the reorganization, improvement, development and evaluation of policy processes, so that a gender equality perspective is incorporated in all policies at all levels and at all stages, by those normally involved in policy-making.

Gender-based violence

The United Nations General Assembly in 1993 adopted the definition of violence against women as "any act that results in, or is likely to result in, physical, sexual, or psychological harm or suffering to women, including threats of such acts, coercion or arbitrary deprivation of liberty, whether occurring in public or private life. It encompasses, but is not limited to: physical, sexual and psychological violence occurring in the family, including battering, sexual abuse of female children in the household, dowry-related violence, marital rape, female genital cutting and other traditional practices harmful to women, non-spousal violence and violence related to exploitation; physical, sexual and psychological violence occurring within the general community, including rape, sexual abuse, sexual harassment and intimidation at work, in educational institutions and elsewhere; trafficking in women and forced prostitution; and physical, sexual and psychological violence perpetrated or condoned by the state, wherever it occurs."

GNP+

Global Network of People Living with HIV/AIDS

HAART

Highly active antiretroviral therapy. The name given to treatment regimens recommended by leading HIV experts to aggressively suppress viral replication and progress of HIV.

Health sector reform

A process that seeks changes in health sector policies, financing, and organization of services, as well as in the role of government, to reach national health objectives. Sector reform is by definition sector-wide in that it affects more than one service, supply, or clinical policy, and more than one provider, institution, or geographic location. Typical goals that countries have for their health sector reform efforts include improvements in access, equity, quality, efficiency and/or sustainability of their health care services.

Highly active anti-retroviral therapy

The name given to treatment regimens recommended by leading HIV experts to aggressively suppress viral replication and progress of HIV disease.

High-risk pregnancy

A pregnant woman who is below 18 years of age or more than 34 years; or who has already had three or more live births; or when birth would occur within 24 months of a previous live birth.

HIV

Human immunodeficiency virus. The virus that causes AIDS. Two types of HIV are currently known: HIV-1 and HIV-2. Worldwide, the predominant virus is HIV-1. Both types of the virus may be transmitted by sexual contact, through blood, and from mother to child (either before or during birth, or through breast feeding), and they appear to cause clinically indistinguishable AIDS. However, HIV-2 is less easily transmitted, and the period between initial infection and illness is longer in the case of HIV-2.

While some individuals experience mild HIV-related disease soon after initial infection, nearly all then remain well for years. As the virus gradually damages their immune system, they begin to develop opportunistic infections of increasing severity, including diarrhoea, fever, tuberculosis, pneumonia, lymphoma and Kaposi's sarcoma.

Hormonal contraception

Systemic methods of contraception based on either a progestagen combined with an oestrogen or a progestagen alone. The methods of delivery include pills (oral contraceptives), injectables and implants. All are reversible.

Human immunodeficiency virus

The virus that causes AIDS. Two types of HIV are currently known: HIV-1 and HIV-2. Worldwide, the predominant virus is HIV-1. Both types of the virus may be transmitted by sexual contact, through blood, and from mother to child (either before or during birth, or through breast feeding), and they appear to cause clinically indistinguishable AIDS.

ICPD

International Conference on Population and Development. UN conference held in Cairo in 1994. ICPD was noted as the first population conference to move away from setting demographic targets towards emphasizing people's needs for, and rights to, sexual and reproductive health. It also emphasized the importance of women's interests as components of development.

ICPD has a deadline of 2015 to achieve the targets set in 1994 - targets that are reviewed at five-yearly intervals.

IDPs

Internally displaced persons. Persons or groups of persons who have been forced or obliged to flee or to leave their homes or places of habitual residence, in particular as a result of or in order to avoid the effects of armed conflict, situations of generalized violence, violations of human rights or natural or human-made disasters, and who have not crossed an internationally recognized State border.

IDU

Injecting Drug User

IEC

Information, education and communication. A programme to ensure that clients or potential clients of sexual and reproductive health services are given the means to make responsible decisions about childbearing and about their sexual and reproductive health.

Information involves generating and disseminating general and technical information, facts and issues, in order to create awareness and knowledge.

Education, whether formal or non-formal, is a process of facilitated learning to enable those learning to make rational and informed decisions.

Communication is a planned process aimed at motivating people to adopt new attitudes or behaviour.

Immune deficiency

A breakdown or inability of certain parts of the immune system to function, thus making a person susceptible to certain diseases that they would not ordinarily develop.

Immune system

The body's complicated natural defence against disruption caused by invading foreign agents (e.g. microbes, viruses).

Immunodeficiency

Immune deficiency. A breakdown or inability of certain parts of the immune system to function, thus making a person susceptible to certain diseases that they would not ordinarily develop.

Implant

Hormonal contraception. Systemic methods of contraception based on either a progestagen combined with an oestrogen or a progestagen alone. The methods of delivery include pills (oral contraceptives), injectables and implants. All are reversible.

Pills (two types):

Combined oral contraceptives (COCs) contain synthetic oestrogen and progestagen. They can be monophasic, i.e. a fixed concentration of hormones throughout 21 days of the 28-day menstrual cycle, or multiphasic, with two (biphasic) or three (triphasic) variations of concentration throughout the cycle.

Progestagen-only pills (POPs) contain only a progestagen, in a smaller dose than in COCs.

Injectables are longer lasting than oral contraceptives. The first were composed of progestagen only, the most common being depot medroxyprogesterone acetate, or DMPA, which lasts three months, and norethisterone oenanthate, or NET-EN, which lasts two months. The newer monthly injectables contain both oestrogen and progestagen.

Subdermal implants are even longer acting (approximately five years) and contain low doses of progestagen. Six thin silicone rubber capsules are inserted subdermally in the woman's arm by a minor surgical procedure under local anaesthesia. The implants may be removed at any time.

IMR

Infant mortality rate. The number of deaths of infants aged under one year per 1,000 live births in a given period, usually a year. It is a useful indicator of the health status not only of infants, but also of whole populations and of the socio-economic conditions under which they live. In addition, the infant mortality rate is a sensitive indicator of the availability, utilization, and effectiveness of health care, particularly perinatal care.

IMS

Integrated management system. A system which integrates the five components of the management process:

Mission statement in which goals and objectives describe the values and purpose of an organization, the medium-term goals it intends to reach and the objectives it wants to achieve. The statement's goals and objectives are reached through a strategic planning exercise.

Strategies which define the approaches which the organization uses in order to achieve its objectives.

Structures which represent the main functions within an organization and how they relate to each other.

Systems which describe the planning, programming, programme budgeting and reporting mechnisms.

Monitoring and evaluation which enable the organization to monitor its progress and assess its performance on the basis of objective-related indicators.

All these components are integrated by the mutual effect and impact they have on each other.

Indicators

A certain condition, capability, or numerical measure which, when recorded, collected, and analysed, makes complex concepts more readily measurable and allows managers and evaluators to compare actual programme results with expected results.

Infant mortality rate

The number of deaths of infants aged under one year per 1,000 live births in a given period, usually a year.

Infertility

Infertility is often defined and usually understood as the inability of couples of reproductive age, who are having sexual intercourse without contraception, to establish pregnancy within a specified period of time.

Infibulation

Female genital cutting. A traditional practice that involves cutting away parts of the female external genitalia, or other injury to the female genitals, for cultural or other non-therapeutic reasons, rendering intercourse and childbirth painful and potentially hazardous. It is usually carried out by traditional practitioners under unhygienic conditions. Also referred to as female genital mutilation or female circumcision.

The World Health Organization has classified female genital cutting into four main groupings:

Type I clitoridectomy involves the removal of the prepuce (clitoral hood), sometimes together with part or all of the clitoris. This is what is commonly referred to as 'Sunna circumcision'.

Type II involves excision, where both the clitoris and part or all of the labia minora (inner vaginal lips) are removed.

Type III (infibulation) is where the clitoris is removed, some or all of the labia minora are amputated and incisions are made on the labia majora (outer lips) to create a raw surface. These raw surfaces are either stitched together and/or kept in contact until they seal as a 'hood of skin' covering the urethra and most of the vaginal opening. A small opening is created to allow the flow of urine and menstrual blood.

Type IV is an unclassified category that includes other operations on the external genitalia including introcision, piercing or incising the clitoris and/or labia, cauterization, scraping and/or cutting of the vagina, introduction of corrosive substances and herbs into the vagina and similar practices.

Information, education and communication

A programme to ensure that clients or potential clients of sexual and reproductive health services are given the means to make responsible decisions about childbearing and about their sexual and reproductive health.

Information involves generating and disseminating general and technical information, facts and issues, in order to create awareness and knowledge.

Education, whether formal or non-formal, is a process of facilitated learning to enable those learning to make rational and informed decisions.

Communication is a planned process aimed at motivating people to adopt new attitudes or behaviour.

Informed choice

Voluntary decision by a client to use, or not to use, a contraceptive method (or accept a sexual and reproductive health service) after receiving adequate information regarding options, risks, advantages and disadvantages of all available methods.

Injectables

Hormonal contraception. Systemic methods of contraception based on either a progestagen combined with an oestrogen or a progestagen alone. The methods of delivery include pills (oral contraceptives), injectables and implants. All are reversible.

Pills (two types):

Combined oral contraceptives (COCs) contain synthetic oestrogen and progestagen. They can be monophasic, i.e. a fixed concentration of hormones throughout 21 days of the 28-day menstrual cycle, or multiphasic, with two (biphasic) or three (triphasic) variations of concentration throughout the cycle.

Progestagen-only pills (POPs) contain only a progestagen, in a smaller dose than in COCs.

Injectables are longer lasting than oral contraceptives. The first were composed of progestagen only, the most common being depot medroxyprogesterone acetate, or DMPA, which lasts three months, and norethisterone oenanthate, or NET-EN, which lasts two months. The newer monthly injectables contain both oestrogen and progestagen.

Subdermal implants are even longer acting (approximately five years) and contain low doses of progestagen. Six thin silicone rubber capsules are inserted subdermally in the woman's arm by a minor surgical procedure under local anaesthesia. The implants may be removed at any time.

Integrated management system

A system which integrates the five components of the management process:

Mission statement in which goals and objectives describe the values and purpose of an organization, the medium-term goals it intends to reach and the objectives it wants to achieve. The statement's goals and objectives are reached through a strategic planning exercise.

Strategies which define the approaches which the organization uses in order to achieve its objectives.

Structures which represent the main functions within an organization and how they relate to each other.

Systems which describe the planning, programming, programme budgeting and reporting mechnisms.

Monitoring and evaluation which enable the organization to monitor its progress and assess its performance on the basis of objective-related indicators.

All these components are integrated by the mutual effect and impact they have on each other.

Internally displaced persons

Persons or groups of persons who have been forced or obliged to flee or to leave their homes or places of habitual residence, in particular as a result of armed conflict, situations of generalized violence, violations of human rights or natural or human-made disasters, and who have not crossed an internationally recognized state border.

International Conference on Population and Development

UN conference held in Cairo in 1994. ICPD was noted as the first population conference to move away from setting demographic targets towards emphasizing people's needs for, and rights to, sexual and reproductive health. It also emphasized the importance of women's interests as components of development.

ICPD has a deadline of 2015 to achieve the targets set in 1994 - targets that are reviewed at five-yearly intervals.

Intrauterine (contraceptive) device

A long-term, reversible method of contraception, involving the insertion into the uterus of a small flexible device of metal/plastic/hormonal materials. IUDs are effective for at least four years, and many for much longer.

IUD

Intrauterine device. A long-term, reversible method of contraception, involving the insertion into the uterus of a small flexible device of metal/plastic/hormonal materials. IUDs are effective for at least four years, and many for much longer.

KAP survey

Knowledge, attitudes and practice survey. Survey undertaken to establish the current situation with regard to contraceptive use. KAP surveys were started in the 1950s to measure the spread of family planning throughout the world. By showing that there were many women who would like to space or limit their births but who did not know about or have access to family planning services (sometimes called the KAP gap), they provided the first estimates of the unmet need for family planning.

Knowledge management

Knowledge is information that provides guidance for action, and is made up of data, information, experience and expertise. Knowledge management is about systematically creating, organizing and re-using the wealth of knowledge and experience of an organization and its partners to achieve organizational objectives in the most effective manner. Knowledge management is also about sharing knowledge to make it available to the widest possible audience both internally and externally through different consultative processes.

Knowledge sharing

Knowledge sharing involves sharing knowledge and experience internally and with local, national and global partners to improve organizational performance and effectiveness.

See Knowledge Management

Knowledge, attitudes and practice survey

Survey undertaken to establish the current situation with regard to contraceptive use. KAP surveys were started in the 1950s to measure the spread of family planning throughout the world. By showing that there were many women who would like to space or limit their births but who did not know about or have access to family planning services (sometimes called the KAP gap), they provided the first estimates of the unmet need for family planning.

LAM

A short term method of preventing pregnancy after birth. It is based on evidence that for six months after birth a very high degree of protection naturally occurs against pregnancy, if the mother is fully or nearly fully breast-feeding. It thus encourages breast-feeding and introduces mothers to the concept of planning births.

Life expectancy

The average number of additional years a person would live if current mortality conditions were to continue.

Low dose pill

A combined contraceptive pill that contains 35 micrograms of oestrogen or less.

Manual vacuum aspiration

A method of pregnancy termination in which the contents of the uterus are removed by suction, using a hand-held syringe.

Market analysis

Typically includes a survey of clients (their needs, satisfaction with services, socio-economic status, etc.), a survey of the community (to learn about potential clients and the existing demand for services), and a survey of other providers in the area (types of services they provide, cost and quality of services, etc.) This provides critical information about under-served populations in their area, the level of access to services, feedback on clients' satisfaction with services, the ability of the clients to pay or the amount they can pay for services, and other information about how to maintain a competitive edge over other providers.

Maternal and child health programmes

Programmes providing health care aimed at improving the health of mothers and children, including efforts to ensure safe motherhood, eliminate unsafe abortion and help women plan and space their births.

Maternal death

When the direct cause of death of a woman is due to pregnancy, usually in the case of a woman who is currently pregnant or who has been pregnant in the last six weeks. Sometimes the last three or 12 weeks is used instead.

Maternal mortality rate

The number of deaths of women due to pregnancy and childbirth complications per 100,000 women aged 15-45 or 15-49 years. This rate measures a woman's lifetime risk of dying associated with reproduction.

Maternal mortality ratio

The number of women who die as a result of pregnancy and childbirth per 100,000 live births. Sometimes 1,000 or 10,000 live births is used instead.

MCH

Maternal and child health programmes. Programmes providing health care aimed at improving the health of mothers and children, including efforts to ensure safe motherhood, eliminate unsafe abortion and help women plan and space their births.

MDGs

Millennium Development Goals. The Millennium Development Goals are an ambitious agenda for reducing poverty and improving lives that world leaders agreed on at the Millennium Summit in September 2000. For each goal one or more targets have been set, most for 2015, using 1990 as a benchmark:

1. Eradicate extreme poverty and hunger

2. Achieve universal primary education

3. Promote gender equality and empower women

4. Reduce child mortality

5. Improve maternal health

6. Combat HIV/AIDS, malaria and other diseases

7. Ensure environmental sustainability

8. Develop a global partnership for development

Menstrual regulation

Evacuation of the uterus of a woman who has missed her menstrual period by 14 days or fewer, who previously had regular periods and who has been at risk of conception. In some countries menstrual regulation is legal, even though therapeutic abortion is not.

Method mix

A summary, usually expressed in percentages, of the proportion of users in a specific population using each contraceptive method.

Microbicide

Microbicides are substances that may be able substantially to reduce transmission of and infection with HIV and other sexually transmitted infections (STIs) when applied either in the vagina or rectum. They could therefore be used by both women and men who have sex with men. However, at present, microbicides are still under development and are yet to be shown to be effective against HIV and/or STIs.

Mifepristone

Antiprogestagens. Compounds that block the action of the hormone progesterone. Since progesterone is essential for the maintenance of pregnancy, antiprogestagens were first developed for the medical termination of pregnancy. The first to be widely used was mifepristone, popularly known as RU-486.

Millennium Development Goals

The Millennium Development Goals are an ambitious agenda for reducing poverty and improving lives that world leaders agreed on at the Millennium Summit in September 2000. For each goal one or more targets have been set, most for 2015, using 1990 as a benchmark:

1. Eradicate extreme poverty and hunger

2. Achieve universal primary education

3. Promote gender equality and empower women

4. Reduce child mortality

5. Improve maternal health

6. Combat HIV/AIDS, malaria and other diseases

7. Ensure environmental sustainability

8. Develop a global partnership for development

Mini pill

Progesterone/progestagen. Progesterone is the hormone which is released in the period of time after ovulation and before menstruation, and also during the early stages of pregnancy. The progestagen-only pill (POP) is made of a synthetic substance which has the same pharmacological properties as progesterone.

MMCWA

Myanmar Maternal and Child Welfare Association

MMR

Maternal mortality rate. The number of deaths of women due to pregnancy and childbirth complications per 100,000 women aged 15-45 or 15-49 years. This rate measures a woman's lifetime risk of dying associated with reproduction. It is influenced by the likelihood of being pregnant and by the risk of dying in childbirth.

Monitoring

The continuous follow-up of activities to ensure that they are proceeding according to plan and are on schedule and/or to signal the need for adjustment.

Morbidity

The incidence and /or prevalence of certain diseases or disabilities. It is usually expressed as a rate: the number of cases of disease per 1,000 persons at risk.

Morning-after pill

Use of the expression ‘morning-after pill’ is misleading. Hormonal treatment and IUDs can be effective up to five days after intercourse.

See Emergency Contraception

Mother-to-child transmission

Transmission of HIV from women to their fetus during pregnancy, delivery or their infant during breast-feeding.

MR

Menstrual regulation. Evacuation of the uterus of a woman who has missed her menstrual period by 14 days or fewer, who previously had regular periods and who has been at risk of conception. It may be performed before proof of pregnancy. A procedure commonly used is that of uterine evacuation using a small flexible plastic cannula in association with a hand-held gynaecological syringe (manual vacuum evacuation). It can be carried out by a range of trained personnel, from gynaecologists to paramedics. In some countries menstrual regulation is legal, even though therapeutic abortion is not.

MSM

Men who have sex with men.

MTCT

Mother-to-child transmission. Transmission of HIV from women to their fetus during pregnancy, delivery or their infant during breast-feeding.

MVA

Manual Vacuum Aspiration. A method of pregnancy termination in which the contents of the uterus are removed by suction, using either a hand-held syringe.

New user

Someone who chooses to use a contraceptive method for the first time. Some programmes include only those people using contraception for the first time; others include those using a particular method for the first time.

Nulligravida

A woman who has never been pregnant.

Nullipara

A woman who has never given birth to a viable infant.

Objective

A specific, measurable, time-bound change to be brought about in order to reach a goal. Objectives specify the kind of change that will contribute to the goal, and are stated in terms of desired outcome (rather than proposed action).

Obstetric fistulae

A rupture that results in an abnormal passage linking two areas such as the vagina, rectum, bladder, or abdominal cavity. Obstetric fistulae are caused by difficult labour, unsafe abortion, and traditional practices such as female genital cutting.

OC

Oral contraception. Hormonal contraception: systemic methods of contraception based on either a progestagen combined with an oestrogen or a progestagen alone. The methods of delivery include pills (oral contraceptives), injectables and implants. All are reversible.

OI

Opportunistic illnesses. People with HIV infection have a high risk for a wide range of illnesses due to HIV risk

factors and HIV itself. Among the most severe illnesses are the 26 AIDS-defining opportunistic illnesses (OIs) that occur as a result of HIV disease progression, and generally occur only after substantial damage to the immune system.

Operations research

A process of programme evaluation intended to help managers and decision makers improve existing programmes and activities and find practical solutions to problem situations.

Opportunistic illnesses

People with HIV infection have a high risk for a wide range of illnesses due to HIV risk

factors and HIV itself. Among the most severe illnesses are the 26 AIDS-defining opportunistic illnesses (OIs) that occur as a result of HIV disease progression, and generally occur only after substantial damage to the immune system.

Oral rehydration therapy

Increased intake of acceptable fluids, including plain fluids found at home and oral rehydration solutions.

ORT

Oral rehydration therapy. Increased intake of acceptable fluids, including plain fluids found at home and oral rehydration solutions.

Outlet

The final distribution point where clients receive their contraceptives (clinic, pharmacy, CBS workers, etc.).

OVC

Orphans and Vulnerable Children

Ovulation method

Also known as the 'Billings Method' - see Periodic Abstinence

Patient flow analysis

Client flow analysis. The process of determining the efficiency of service delivery operations in a health facility. It is based on observations made of the movement of clients through the health facility and tracks, in particular, the amount of time a client spends waiting to be seen by a provider and the amount of contact time a client has with each of the clinic's service providers. Also known as patient flow analysis.

Pelvic inflammatory disease

Inflammation of the pelvic organs, especially the uterus and fallopian tubes. PID is a major complication of women with chlamydial and gonococcal infections, and is associated with long-term morbidity such as chronic abdominal pain, menstrual disturbances, tubal pregnancy and infertility.

Perinatal death

Death of a fetus after 28 weeks of pregnancy or of a child within the first week of life. The perinatal mortality rate is the number of deaths per 1,000 total births.

Periodic abstinence

A method of contraception in which couples avoid sexual intercourse during the fertile phase of the menstrual cycle. This method depends on the ability of the couple to identify the fertile phase (sometimes called fertility awareness), and the couple's motivation and discipline to practise abstinence when required.

PID

Pelvic inflammatory disease. Inflammation of the pelvic organs, especially the uterus and fallopian tubes. PID is a major complication of women with chlamydial and gonococcal infections, and is associated with long-term morbidity such as chronic abdominal pain, menstrual disturbances, tubal pregnancy and infertility.

PLWA

Person or People living with HIV/AIDS

Policy

A set of decisions to pursue courses of action for achieving goals.

Population distribution

The arrangement of population geographically as it is spread over a defined area such as community, district, capital city, country, region, etc. Knowing the distribution of population is important to managers as they plan new programmes and the locations of service facilities.

Population projection

The computation of future population size and characteristics based on assumptions about future trends in fertility, mortality and migration.

Population pyramid

A double bar chart showing the age-sex structure of a population. Horizontal bar graphs for each sex are placed side by side with the youngest age at the bottom. The figure narrows at the top, hence the name pyramid. Fast-growing populations resemble pyramids, as each new birth cohort is larger than the one before, but slow-growing populations have a more even distribution.

Post-coital contraception

Emergency contraception. A method of contraception used to avoid pregnancy after a single act of sexual intercourse that was unprotected due to lack of use or failure of a contraceptive. Two types are available:

Hormonal treatment with high-dose oestrogen, a low-dose oestrogen-progestagen combination or progestagen alone. Emergency Contraception Pills (ECPs) should be taken as soon as possible after unprotected sex.

The insertion of an intra-uterine device, which has to be carried out within five days of unprotected sex.

Emergency contraception pills (ECPs) are thought to prevent ovulation, fertilization, and/or implantation. ECPs are not effective once the process of implantation has begun, and will not cause abortion.

Recent studies have provided new information concerning the regimen for levonorgestrel-only and Yuzpe ECPs. This research indicates that ECPs can prevent pregnancy up to five days (120 hours) after unprotected intercourse.

Post-partum

Occurring in the period immediately after childbirth. Often used to describe temporary conditions which start and occur as a result of childbirth.

Poverty reduction strategy

A country-driven, results-oriented, comprehensive and long-term health strategy for poverty reduction.

Poverty reduction strategy paper

A framework for development assistance to reduce poverty. See Poverty Reduction Stategy

Pregnancy wastage

Loss of fetus at any stage during the pregnancy. Pregnancy wastage includes spontaneous abortions (miscarriages) and stillbirths. It excludes intentional loss through induced abortion.

Prenatal sex selection

The decision to abort a fetus having discovered its sex in early pregnancy. This practice usually occurs in societies with strong son preference where female fetuses are aborted if a son, or more sons are desired.

Primary health care

Package of basic health services provided at the lowest level of a health system.

Progesterone/progestagen

Progesterone is the hormone which is released in the period of time after ovulation and before menstruation, and also during the early stages of pregnancy. The progestagen-only pill (POP) is made of a synthetic substance which has the same pharmacological properties as progesterone.

PRS

Poverty reduction strategy. A country-driven, results-oriented, comprehensive and long-term health strategy for poverty reduction.

PRSP

Poverty reduction strategy paper. A framework for development assistance to reduce poverty. See Poverty Reduction Stategy

Refugee

Under the UN Convention 1951, a refugee is a person who, owing to well-founded fear of

persecution for reasons of race, religion, nationality or membership of a particular social

group or political opinion, is outside the country of his/her nationality and is unable or, owing to such fear, is unwilling to avail him/herself of the protection of that country; or who, not having a nationality or being outside the country of his/ her former habitual residence, is unable or, owing to such fear, is unwilling to return to it.

Replacement-level fertility

The level of fertility at which each woman will, on average, be succeeded by one daughter who survives to have a daughter herself. This will depend on mortality conditions, but in countries where mortality below the age of reproduction is low, it is usually taken to be 2.1 children per woman.

Reproductive age

The span of ages at which individuals are capable of becoming parents. The phrase can be applied to men and women but most frequently refers to women.

Reproductive health

IPPF endorses the definition of reproductive health agreed at the International Conference on Population and Development, which stated: "Reproductive health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity, in all matters relating to the reproductive system and to its functions and processes. Reproductive health therefore implies that people are able to have a satisfying and safe sex life and that they have the capability to reproduce and the freedom to decide if, when and how often to do so. Implicit in this last condition is the right of men and women to be informed and to have access to safe, effective, affordable and acceptable methods of family planning of their choice, as well as other methods of their choice for regulation of fertility.

Reproductive health commodity security

Usually referred to by its acronym RHCS, Reproductive Health Commodity Security is defined as a secure supply and choice of quality contraceptives, condoms and other essential reproductive health commodities to meet every person's needs at the right time and in the right place. RHCS is a pre-requisite to achieving the ICPD goal of universal access to reproductive health care by the year 2015.

Reproductive rights

These rights rest on the recognition of the basic right of all couples and individuals to decide freely and responsibly the number, spacing and timing of their children and to have the information and means to do so, and the right to attain the highest standard of sexual and reproductive health. It also includes their right to make decisions concerning reproduction free of discrimination, coercion and violence, as expressed in human rights documents.

Reproductive tract infection

A general term for infections affecting the reproductive organs. RTIs include three types of infection: sexually transmitted infections (STIs), infections which are caused by overgrowth of organisms naturally present in the genital tract, such as bacterial vaginosis and vulvovaginal candidiasis, and infections that are a consequence of medical treatment.

RH

Reproductive health. IPPF endorses the definition of reproductive health agreed at the International Conference on Population and Development, which stated:

"Reproductive health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity, in all matters relating to the reproductive system and to its functions and processes. Reproductive health therefore implies that people are able to have a satisfying and safe sex life and that they have the capability to reproduce and the freedom to decide if, when and how often to do so. Implicit in this last condition are the right of men and women to be informed and to have access to safe, effective, affordable and acceptable methods of family planning of their choice, as well as other methods of their choice for regulation of fertility which are not against the law, and the right of access to appropriate health care services that will enable women to go safely through pregnancy and childbirth and provide couples with the best chance of having a healthy infant. In line with the above definition of reproductive health, reproductive health care is defined as the constellation of methods, techniques and services that contribute to reproductive health and well-being by preventing and solving reproductive health problems. It also includes sexual health, the purpose of which is the enhancement of life and personal relations and not merely counselling and care related to reproduction and sexually transmitted diseases."

RHCS

Reproductive health commodity security. Usually referred to by its acronym RHCS, Reproductive Health Commodity Security is defined as a secure supply and choice of quality contraceptives, condoms and other essential reproductive health commodities to meet every person's needs at the right time and in the right place. RHCS is a pre-requisite to achieving the ICPD goal of universal access to reproductive health care by the year 2015.

Rhythm method

Also known as the calendar method - see Periodic Abstinence

RTI

Reproductive tract infection. A general term for infections affecting the reproductive organs. RTIs include three types of infection: sexually transmitted infections (STIs), infections which are caused by overgrowth of organisms naturally present in the genital tract, such as bacterial vaginosis and vulvovaginal candidiasis, and infections that are a consequence of medical treatment.

RU-486 (mifepristone)

Antiprogestagens. Compounds that block the action of the hormone progesterone. Since progesterone is essential for the maintenance of pregnancy, antiprogestagens were first developed for the medical termination of pregnancy. The first to be widely used was mifepristone, popularly known as RU-486.

Safe motherhood

Pregnancy and childbirth with low risk of death or ill health. In order to make motherhood safer, women need regular antenatal advice and care, a good diet during pregnancy, to be attended by trained personnel at delivery, and to have access to treatment for obstetric emergencies. Reducing high rates of maternal mortality and morbidity also depends on reducing the likelihood of women experiencing an unwanted high risk pregnancy, which necessitates the availability of family planning and safe abortion services.

Safer sex

Any sexual practice that aims to reduce the risk of unwanted pregnancy and of passing HIV (and other sexually transmitted infections) from one person to another. Examples are non-penetrative sex or vaginal intercourse with a condom. During unsafe sex, fluids that can transmit HIV and other STIs (semen, vaginal fluid or blood) may be introduced into the body of the sex partner.

SAR

South Asia Region

Sector-wide approaches

Also known as SWAps, a sector-wide approach is a sustained partnership, led by national authorities, to achieve improvements in people's health through a common financing and management arrangement to achieve agreed sectoral milestones and targets. SWAp is a strategy to overcome some of the deficiencies of projectized funding. The ultimate goal of SWAp is to promote the equitable, sustainable and efficient use of all available national and external resources.

Sex education

Basic education about reproductive processes, puberty, sexual behaviour, etc. Sex education may include other information, for example about contraception, protection from sexually transmitted infections and parenthood.

Sex ratio

The ratio of males to females in the population, usually expressed as the number of males per 100 females. This can be calculated for all age groups but the one most usually quoted is the sex ratio at birth.

Sexual and reproductive health

Sexual and reproductive health services

Defined as the constellation of methods, techniques and services that contribute to reproductive health and well-being through preventing and solving reproductive health problems. It also includes sexual health.

Sexual health

IPPF endorses the United Nations definition of sexual health as " the notion of sexual health implies a positive approach to human sexuality and the purpose of sexual health care should be the enhancement of life and personal relations and not merely counselling and care related to reproduction and sexually transmitted diseases."

Sexual intercourse

Penetrative sexual behaviours, including oral sex, anal sex and penile-vaginal sex.

Sexual orientation

Sexual orientation refers to the primary sexual attraction to the same, opposite or both sexes.

Sexual rights

IPPF endorses the definition of sexual rights agreed at the Fourth World Conference on Women, which stated that: "The human rights of women include their right to have control over and decide freely and responsibly on matters related to their sexuality, including sexual and reproductive health, free of coercion, discrimination and violence. Equal relationships between women and men in matters of sexual relations and reproduction, including full respect for the integrity of the person, require mutual respect, consent and shared responsibility for sexual behaviour and its consequences."

Sexuality

The sexual knowledge, beliefs, attitudes, values, and behaviours of individuals. Its dimensions include the anatomy, physiology, and biochemistry of the sexual response system; identity, orientation, roles and personality; and thoughts, feelings, and relationships. The expression of sexuality is influenced by ethical, spiritual, cultural, and moral concerns.

Sexuality counselling

Counselling on issues of sexuality with the aim of creating a climate where clients can express themselves and their concerns relating to sexual relationships and intimacy without fear of discrimination.

See Sexuality.

Sexually transmitted disease

Sexually transmitted infection. Disease resulting from bacteria or viruses and often acquired through sexual contact. Some STIs can also be acquired in other ways (i.e. blood transfusions, intravenous drug use, mother-to-child transmission). The term 'STI' is slowly replacing 'STD' (sexually transmitted disease) in order to include HIV infection. Most STIs, like HIV, are not acquired from partners who are obviously ill, but rather through exposure to infections that are asymptomatic or unnoticeable at the time of transmission.

Sexually transmitted infection

Disease resulting from bacteria or viruses and often acquired through sexual contact. Some STIs can also be acquired in other ways (i.e. blood transfusions, intravenous drug use, mother-to-child transmission). The term 'STI' is slowly replacing 'STD' (sexually transmitted disease) in order to include HIV infection.

Social marketing

Application of private sector marketing techniques to the sale of products which fulfil a social objective, at a price, such as condoms. Marketing is described as having the right product at an accessible place at an affordable price with appropriate promotion to one or more targeted audiences. In the social marketing of contraceptives, existing commercial and retail outlets are used in order to reach people not adequately served by other means; outlets can include pharmacies, grocery shops, petrol stations, barber shops, etc.

Son preference

A desire to have male rather than female children. This is usually due to the perception that sons contribute more to families, through work, continuing the family line and carrying out family rites and rituals, and providing security to their parents in old age.

Spermicides

Chemical contraceptives that inactivate and kill sperm and to a certain extent form a barrier over the cervix. Spermicides are more effective when used in conjunction with other contraceptives such as condoms or diaphragms.

SRH

Sexual and reproductive health. See Sexual Health and also Reproductive Health

SRHR

Sexual and Reproductive Health and Rights

SRHS

Sexual and reproductive health services. Defined as the constellation of methods, techniques and services that contribute to reproductive health and well-being through preventing and solving reproductive health problems. It also includes sexual health.

STD

Sexually Transmitted Disease. Disease resulting from bacteria or viruses and often acquired through sexual contact. Some sexually transmitted infections (STIs) can also be acquired in other ways (i.e. blood transfusions, intravenous drug use, mother-to-child transmission). The term 'STI' is slowly replacing 'STD' (sexually transmitted disease) in order to include HIV infection.

Sterilization

Voluntary surgical contraception. Female and male sterilization (also known as tubectomy, tubal occlusion or tubal ligation and vasectomy) are among the most effective contraceptive methods available for men and women who desire no more children and are associated with low mortality and complication rates. The sterilization procedure blocks either the sperm ducts (the vasa deferentia) or the oviducts (fallopian or uterine tubes) to prevent the sperm and ovum from uniting.

STI

Sexually transmitted infection. Disease resulting from bacteria or viruses and often acquired through sexual contact. Some STIs can also be acquired in other ways (i.e. blood transfusions, intravenous drug use, mother-to-child transmission). The term 'STI' is slowly replacing 'STD' (sexually transmitted disease) in order to include HIV infection. Most STIs, like HIV, are not acquired from partners who are obviously ill, but rather through exposure to infections that are asymptomatic or unnoticeable at the time of transmission.

Strategic gender needs

Changing women's subordinate social status in relation to men, challenging existing roles and promoting more equitable relations between men and women. Achieving strategic gender needs often takes a long time, requires policy and legislative changes and almost always involves empowering women.

Sustainability

The ability of a member association to improve institutional capacity in order to adopt a realistic and innovative strategy and thus provide quality services to its clients. Sustainability may include expanding client bases and generating income through advocacy and local funding mechanisms, while decreasing dependence on funds derived from external donors.

SWAps

Sector-wide approaches. Also known as SWAps, a sector-wide approach is a sustained partnership, led by national authorities, to achieve improvements in people's health through a common financing and management arrangement to achieve agreed sectoral milestones and targets. SWAp is a strategy to overcome some of the deficiencies of projectized funding. The ultimate goal of SWAp is to promote the equitable, sustainable and efficient use of all available national and external resources.

Targets

The desired outcomes quantified and specified in time towards the attainment of the ultimate strategic objectives.

TBA

Traditional birth attendant. This comprises women who provide delivery services in the community. This includes traditional birth attendants who initially acquired their skills by delivering babies themselves or through apprenticeship. (WHO does not include them in the category of 'skilled attendants' who are allowed to provide/manage deliveries).

Teenage

Adolescence. The period of transition from childhood to adulthood, describing both the development to sexual maturity and to psychological and relative economic independence. The World Health Organization uses the 10-19 year age range to define adolescence, with further divisions for early adolescence: 10-14 years, and late adolescence: 15-19 years.

TFR

Total fertility rate. The average number of children that would be born alive to a woman during her lifetime if the age-specific fertility rates of a given year applied throughout her childbearing years.

Total fertility rate

The average number of children that would be born alive to a woman during her lifetime if the age-specific fertility rates of a given year applied throughout her childbearing years.

Traditional birth attendant

This comprises women who provide delivery services in the community. This includes traditional birth attendants who initially acquired their skills by delivering babies themselves or through apprenticeship. (WHO does not include them in the category of 'skilled attendants' who are allowed to provide/manage deliveries).

Traditional methods (of contraception)

Non-supply methods including periodic and post-partum abstinence, total abstinence if for contraceptive reasons, withdrawal, douche and folk methods. They are not reliable contraceptives.

Tubal ligation

Voluntary surgical contraception. Female and male sterilization (also known as tubectomy, tubal occlusion or tubal ligation and vasectomy) are among the most effective contraceptive methods available for men and women who desire no more children and are associated with low mortality and complication rates. The sterilization procedure blocks either the sperm ducts (the vasa deferentia) or the oviducts (fallopian or uterine tubes) to prevent the sperm and ovum from uniting.

Under-five mortality rate

Child mortality rate. The number of deaths of children aged 1-4 years per 1,000 children in that age group over a period of a year. This measure excludes deaths of infants (i.e. children aged less than one year) so an alternative indicator, the under-five mortality rate, is sometimes used which is inclusive.

Under-served groups

Groups not normally or not well served by established service delivery programmes. In family planning, some examples of under-served groups are adolescents, men, the urban poor and those who live in remote areas, and unmarried people.

Unmet need for family planning

Estimates of women who would like to prevent or delay pregnancy but are not using contraception, either because they lack knowledge about family planning or access to services, or because they face cultural, religious and family obstacles.

Unsafe abortion

An induced abortion conducted either by persons lacking the necessary skills or in an environment lacking the minimal medical and hygienic standards, or both. Although the majority of the world's women live in countries where laws permit an induced abortion if a woman requests one and if there are health or social grounds for allowing it, a quarter of women live in countries where there is no access to legal abortion. Even in countries where abortion is legal, women may not be able to obtain abortions easily for reasons of bureaucracy, availability or accessibility. In these circumstances women with unwanted pregnancies frequently resort to unsafe abortion.

Vaccine

A substance that gives immunity against a specific disease.

Vacuum aspiration

A method of pregnancy termination in which the contents of the uterus are removed by suction, using either a hand-held syringe or electric pump.

Vasectomy

Voluntary surgical contraception. Female and male sterilization (also known as tubectomy, tubal occlusion or tubal ligation and vasectomy) are among the most effective contraceptive methods available for men and women who desire no more children and are associated with low mortality and complication rates. The sterilization procedure blocks either the sperm ducts (the vasa deferentia) or the oviducts (fallopian or uterine tubes) to prevent the sperm and ovum from uniting.

VCT

Voluntary counselling and testing. VCT is the process by which an individual undergoes counselling enabling him or her to make an informed choice about being tested for HIV. This decision must be entirely the choice of the individual and he or she must be assured that the process will be confidential.

VFHA

Vanuatu Family Health Association

Violence against women

Gender-based violence. The United Nations General Assembly in 1993 adopted the definition of violence against women as "any act that results in, or is likely to result in, physical, sexual, or psychological harm or suffering to women, including threats of such acts, coercion or arbitrary deprivation of liberty, whether occurring in public or private life. It encompasses, but is not limited to: physical, sexual and psychological violence occurring in the family, including battering, sexual abuse of female children in the household, dowry-related violence, marital rape, female genital cutting and other traditional practices harmful to women, non-spousal violence and violence related to exploitation; physical, sexual and psychological violence occurring within the general community, including rape, sexual abuse, sexual harassment and intimidation at work, in educational institutions and elsewhere; trafficking in women and forced prostitution; and physical, sexual and psychological violence perpetrated or condoned by the state, wherever it occurs."

Vital statistics/events

Demographic data on births, deaths, and stillbirths. Other events such as adoption, marriage, divorce and migration, although strictly speaking not vital events, are nevertheless often included. The registration of vital events is the basic source of information about a population's dynamics.

Voluntary counselling and testing

VCT is the process by which an individual undergoes counselling enabling him or her to make an informed choice about being tested for HIV. This decision must be entirely the choice of the individual and he or she must be assured that the process will be confidential.

Voluntary surgical contraception

Female and male sterilization (also known as tubectomy, tubal occlusion or tubal ligation and vasectomy) are among the most effective contraceptive methods available for men and women who desire no more children and are associated with low mortality and complication rates. The sterilization procedure blocks either the sperm ducts (the vasa deferentia) or the oviducts (fallopian or uterine tubes) to prevent the sperm and ovum from uniting.

VSC

Voluntary surgical contraception. Female and male sterilization (also known as tubectomy, tubal occlusion or tubal ligation and vasectomy) are among the most effective contraceptive methods available for men and women who desire no more children and are associated with low mortality and complication rates. The sterilization procedure blocks either the sperm ducts (the vasa deferentia) or the oviducts (fallopian or uterine tubes) to prevent the sperm and ovum from uniting.

WFS

World fertility survey. An international programme of research on human fertility carried out between 1974 and 1982. At the time, the World Fertility Survey was the largest social survey undertaking ever, with nationally representative, internationally comparable surveys carried out in 42 developing and 20 developed countries.

Window period

Time from infection with HIV until antibodies are detected.

Withdrawal

One of the oldest known methods of contraception in which the man withdraws his penis from the vagina before ejaculation. Also known as coitus interruptus. Not an effective method of preventing pregnancy.

World fertility survey

An international programme of research on human fertility carried out between 1974 and 1982. At the time, the World Fertility Survey was the largest social survey undertaking ever, with nationally representative, internationally comparable surveys carried out in 42 developing and 20 developed countries.

Young people

Those who are aged between 10-24 years.

Youth

The World Health Organization refers to those in the 15-24 age range as youth.