UCLA School of Public Health Department of Community Health Sciences. CHS 431 Foundations of Reproductive Health

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1 UCLA School of Public Health Department of Community Health Sciences CHS 431 Foundations of Health Spring Quarter 2010 Tuesday 3:00 5:50 PM CHS credits Instructor: Jessica Gipson, MPH PhD Office hours: Mondays 3 5pm Office: CHS B jgipson@ucla.edu Phone: Course Description Understanding reproductive technologies and practices is critical for public health students interested in designing programs to address problems such as unwanted pregnancy, family planning, and sexually transmitted diseases. This course will examine the foundations of reproductive health from a medical and social science perspective with particular attention to implications for public health programs, health services, and policy. Topics to be covered include: the anatomy and physiology of the male and female reproductive health tracts; methods of birth control; medical and surgical abortion; infertility; maternal care; and how gender and power intersect to influence reproductive health outcomes. Knowledge and Skill Objectives CHS 431 is designed to provide an extensive overview of various methods and issues related to reproductive health. Upon completion, the student should be able to: a. Justify the inclusion of sexual and reproductive health as a public health priority; b. Understand the basic anatomy and physiology of the male and female reproductive tracts; c. Describe the major methods of birth control and abortion; d. Identify sexually transmitted diseases, and their treatment and prevention; e. Identify the prevalence, major causes, and treatment of infertility; f. Identify and describe the leading causes of maternal morbidity and mortality in the U.S. and developing country settings g. Understand and describe the influences of gender norms and power on sexual and reproductive health outcomes.

2 ASPH Core Competencies In an effort to identify and standardize the content of Masters in Public Health training programs, the Associated Schools of Public Health (ASPH) have developed the MPH Core Competencies: This course will partially or completely fulfil the following ASPH competencies: Epidemiology Identify the principles and limitations of public health screening programs (for some reproductive health related issues). Describe a public health problem in terms of magnitude, person, time and place. Social and Behavioral Sciences Identify the causes of social and behavioral factors that affect health of individuals and populations. Describe the role of social and community factors in both the onset and solution of public health problems. Diversity and Culture Describe the roles of, history, power, privilege and structural inequality in producing health disparities. Differentiate among availability, acceptability, and accessibility of health care across diverse populations. Public Health Biology Describe how behavior alters human biology. Identify the ethical, social and legal issues implied by public health biology. Professionalism Analyze determinants of health and disease using an ecological framework. Analyze the potential impacts of legal and regulatory environments on the conduct of ethical public health research and practice. Program Planning Describe how social, behavioral, environmental, and biological factors contribute to specific individual and community health outcomes. Systems Thinking Analyze the impact of global trends and interdependencies on public health related problems and systems. Computer Policy: BE GREEN, NOT MEAN. The use of computers to take lecture notes or review readings is fine. However, Facebooking, IMing, etc. during class is disrespectful to the time, energy (and for you cost!) that we ve all invested to be here. Please be considerate of your fellow classmates and the professor by using your computer sparingly and respectfully. 2

3 Course Requirements 1. This course has no prerequisites, but it is intended for graduate students only. 2. Students are expected to master the course content through readings, attendance and participation in weekly class sessions. 3. Grading will be determined as follows: Requirement Weight Midterm (50 min) 30% Final (3 hours) 45% Class Activity and Participation 25% Methods of Course Evaluation Midterm (April 27, 3 3:50pm): The format of the midterm will be multiple choice and short answer questions. Final (June 8, 3 6pm): The format of the final will be multiple choice, short answer and essay questions. Class Activity: Each week a group of 2 3 people will make a 10 minute (MAX) presentation to the rest of the class. You can choose one of the following presentations: 1) conduct an edutainment activity in which you show/teach the class an interactive reproductive health learning activity which could be used for subsequent workshops or training of trainers meetings, or 2) demonstrate the use of an informative and helpful reproductive health resource (e.g., interactive website or SMS service). Remember this class lasts 3 hours so make it fun and engaging! Reading 1. There is one required textbook for the course: Robert A. Hatcher et al. (2008). Contraceptive Technology. 19th Revised Edition. Ardent Media, Inc. The medical bookstore has agreed to match Amazon.com s price of $61.62 (much better than $79.95 list price!) 2. This will be supplemented with readings available on the course website: COMHLT

4 Class Schedule and Readings Week Topic/Lecturer Required Readings Week 1 March 30 Course Logistics Sexual and Health as a Public Health and Human Rights Issue Hatcher, et al. Chapter 1 Obaid, T.A. (2009) Fifteen years after the International Conference on Population and Development: What have we achieved and how do we move forward? International Journal of Gynecology and Obstetrics, 106 (2): Greer, G. (2009) To have or not to have: The critical importance of reproductive rights to the paradox of population policies in the 21st century. International Journal of Gynecology and Obstetrics, 106 (2): Glasier, A., Gülmezoglu, A.M., Schmid, G.P., Moreno, C.G., Van Look, P.F. (2006) Sexual and reproductive health: a matter of life and death. Lancet, 368 (9547): International Conference on Population and Development, Cairo 1994, Programme of Action: Week 2 April 6 Week 3 April 13 Sexual and Health across the Lifecourse Human System Part I (Lu) Short term Contraceptive Methods Part I Lu, M.C., Halfon, N. (2003) Racial and ethnic disparities in birth outcomes: a life course perspective. Maternal and Child Health Journal, 7 (1): Bearinger, L.H., Sieving, R.E., Ferguson, J., Sharma, V. (2007) Global perspectives on the sexual and reproductive health of adolescents: patterns, prevention, and potential. Lancet, 369 (9568): Essentials of Anatomy & Physiology 4th edition, Ch. 20, The System (pp ) Hatcher, et al. Chapters 6,9 13 Hatcher, et al. Chapters 2, 20 Human System Part II (Lu) Week 4 April 20 Short term Contraceptive Methods Part II Hatcher, et al. Chapters 14 16, 18 Heimburger, A. & Ward, V. (2008). Putting the S Back into Sexual and Health. International Journal of Sexual Health, 20(1),

5 Week 5 April 27 Week 6 May 4 Week 7 May 11 Where is the S in SRH? Addressing Sexuality and Pleasure Midterm (50 min) Long term Contraceptive Methods (Parvataneni) Female Health Issues in the U.S. Clinical Perspectives on Maternal Morbidity and Mortality in the U.S. (Gregory) Unintended Pregnancy and Abortion in the U.S. Clinical Aspects of Abortion (Rible) Higgins JA and Hirsch JS. (2007) The Pleasure Deficit: Revisiting the "Sexuality Connection" in Health. Perspectives on Sexual and Health 39(4): Hilbera, et al. (2010) A cross cultural study of vaginal practices and sexuality: Implications for sexual health. Social Science & Medicine 70: Lindau, S.T., Schumm, L.P., Laumann, E.O., Levinson, W., O'Muircheartaigh, C.A., Waite, L.J. (2007) A study of sexuality and health among older adults in the United States. New England Journal of Medicine, 357 (8): Philpott, et al. (2006) Promoting protection and pleasure: amplifying the effectiveness of barriers against sexually transmitted infections and pregnancy. The Lancet 368: Hatcher, et al. Chapters 7, 8, 17 COMPLETE MID COURSE EVALUATION Contraceptive Technology, Chapter 22 Geller SE, et al. (2006) Morbidity and Mortality in Pregnancy: Laying the Groundwork for Safe Motherhood. Women s Health Issues 16: Berg CJ, et al. (2009) Overview of Maternal Morbidity During Hospitalization for Labor and Delivery in the United States and Obstetrics & Gynecology 113(5) Hatcher, et al. Chapter 24 Finer LB and Henshaw SK. (2006) Disparities in Rates of Unintended Pregnancy in the United States, 1994 and 2001 Perspectives on Sexual and Health, 8(2): Jones RK, et al. (2008) Abortion in the United States: Incidence and Access to Services, 2005 Perspectives on Sexual and Health, 40(1):6 16. Santelli, J., et al. (2003) The measurement and meaning of unintended pregnancy, Perspectives on Sexual and Health, 35 (2):

6 Week 8 May 18 Week 9 May 25 Week 10 June 1 Tract and Sexually Transmitted Infections (Javanbakht) Infertility in Domestic and International Settings Global SRH Issues Fistula and Unsafe Abortion in Uganda (Stenson) Male Sexual and Health Gender, Power, and Health: Implications for Finer LB, et al. (2006 ) Timing of steps and reasons for delays in obtaining abortions in the United States, Contraception 74: Hatcher, et al. Chapters 21 and 25 Chandra A and Stephen EH. (2010) Infertility service use among U.S. women: 1995 and 2002, Fertility and Sterility, 93(3): Fidler, A.T., & Bernstein, J. (1999). Infertility: From a personal to a public health problem. Public Health Reports, 114, Rutstein SO, Shah IH. Infecundity, infertility, and childlessness in developing countries. DHS Comparative Reports No.9. Calverton, MD: ORC Macro and Geneva: World Health Organization, Inhorn MC and van Balen F. Infertility around the globe : new thinking on childlessness, gender, and reproductive technologies. Berkeley : University of California Press, Garcia Moreno C, et al. (2006) Prevalence of intimate partner violence: findings from the WHO multi country study on women s health and domestic violence, Lancet 368: Wall, et al. (2005) The Obstetric Vesicovaginal Fistula in the Developing World. Obstetrical and Gynecological Survey 60(7 Suppl):READ S3 S27 ONLY. Feldman Jacobs, C. and Clifton, D. Female Genital Mutilation/Cutting: Data and Trends, Population Reference Bureau, Grimes, D.A., et al. (2006) Unsafe abortion: the preventable pandemic, Lancet, 368 (9550): Ronsmans, C., Graham, W Maternal Mortality: who, when, where and why, The Lancet, Maternal Survival Series, pp Gipson, J.D., et al. (2008) The effects of unintended pregnancy on infant, child, and parental health: A review of the literature, Studies in Family Planning, 39 (1): In Their Own Right: Addressing the Sexual and Health Needs of Men Worldwide. Alan Guttmacher Institute (2003) Blanc AK. (2001) The Effect of Power in Sexual Relationships on Sexual and Health: An Examination of the Evidence, Studies in Family Planning 32(3): Padilla M, et al. (2008) Stigma, social inequality, and HIV risk disclosure among Dominican male sex workers, Social Science and Medicine 67:

7 Men, Women, and Couples Dudgeon MR and Inhorn MC. (2004) Men s influences on women s reproductive health: medical anthropological perspectives, Social Science and Medicine 59: Gipson, J.D. and Hindin, M.J. (2008) "Having another child would be a life or death situation for her": Understanding pregnancy termination among couples in rural Bangladesh, American Journal of Public Health, 98 (10): FINAL EXAM: JUNE 8 th CHS pm List of lecturers Marjan Javanbakht, MPH, PhD: Adjunct Assistant Professor, Department of Epidemiology, UCLA School of Public Health Kimberly Gregory, MD, MPH: Vice Chair, Women's Healthcare Quality and Performance Improvement, Cedars Sinai Hospital; Associate Professor, UCLA School of Medicine; Adjunct Associate Professor, UCLA School of Public Health. Michael Lu, MD, MPH: Associate Professor, Department of Obstetrics & Gynecology, David Geffen School of Medicine at UCLA; Associate Professor, Department of Community Health Sciences, UCLA School of Public Health Ram Parvataneni, MD: OB/GYN, Department of Obstetrics and Gynecology, UCLA School of Medicine Radhika Rible, MD: OB/GYN, Department of Obstetrics and Gynecology, UCLA School of Medicine Amy Stenson, MD, MSc: OB/GYN, BIRCWH Scholar and Clinical Instructor, Department of Obstetrics and Gynecology, UCLA School of Medicine 7