Text in Afrikaans / Die effek van die klient-verpleegkundige-verhoudings op kliente se keuse en volgehoue gebruik van kontraseptiewe metodes het tot op hede baie min aandag geniet. Die doel van hierdie studie was 'n ondersoek na die ongetroude klient se persepsie van die verpleegkundige se houding. Die steekproef het bestaan uit 99 kliente (tussen die ouderdomme van 15 en 50 jaar) wat die betrokke reproduktiewegesondheidsklinieke in die Kaapse Metropool besoek het. Die eerste 20 kliente wat die kliniek besoek het, is genader om 'n vraelys in te vul. Hierdie studie toon 'n algehele positiwiteit, naamlik 58,3% teenoor die houding van geregistreerde verpleegkundiges. Die meerderheid van die kliente (88,0%) het aangedui dat hulle weer die kliniek sal besoek wat dus die kliente se tevredenheid toon. / The effect of the client-registered nurse relationship on clients' choice and continuous use of contraceptive methods has until now received very little attention. The purpose of this study was to explore unmarried clients' perception of the attitude of the registered nurse. The sample existed of 99 clients (between the ages of 15 and 50 years) who visited the relevant reproductive health clinics in the Cape Metropole. The first 20 clients who visited the clinic were approached to complete a questionnaire. This study shows an overall positivity of 58,3% with regard to the attitude of registered nurses. Most of the clients (88,0%) indicated that they would visit the clinic again, which indicate their satisfaction. / Health Studies / M.A. (Nursing Science)

Background AIDS remains one of the world’s most serious health challenges affecting more females than men. The differences in the spread of Human Immunodeficiency Virus (HIV) among gender groups stem from biology, sexual behaviour and socially constructed gender differences between women and men in roles and responsibilities, access to resources and decision-making power. It could also be due to the females’ status in society which could be justified by lower economic and decision making ability. Purpose The purpose of this study was to explore and describe the role of gender in the spread of HIV among women of reproductive age in Ethiopia; with the view of developing gender sensitive HIV and AIDS prevention strategies. Methods The study used sequential mixed method with quantitative and qualitative paradigm. During first phase of the study, health facility based descriptive cross-sectional study design was used. Data was collected from 422 respondents using a structured questionnaire. Forty participants were recruited by purposive sampling from representatives working in reproductive health or related fields. Results About 83.2% of respondents reported that sexual intercourse discussion should be initiated by male partners. This showed that majority of respondents were dependent on their male partners in decision-making regarding sexual matters in their relationship. Multiple sexual partners were common among the respondents. One third of the respondents reported to have had intercourse with more than one partner during the past twelve months of the study period. Higher proportion of respondents (61.4%, n=259) had never used condom during sexual intercourse with their partner/s. As a result these risky sexual practices are a potential threat for spread of HIV and AIDS among women. Thus developed guidelines would alleviate the existing problems through implementation of strategies of HIV and AIDS prevention to enhance women’s status at household and different administrative structure level. Conclusion Gender disparities in relation to negotiating sexual relations among the study respondents were found to be still relevant. The culture that has placed men at the helm of leadership in sexual matters is strongly upheld and that includes who recommends use of preventive measures and who regulates when and how to enter into a sexual relationship. Guidelines for gender sensitive prevention strategies if applied appropriately would educate women and men to make decision about what directly affects their health / Health Studies / D. Litt. et Phil. (Health Studies)

Made available in DSpace on 2012-09-06T01:11:06Z (GMT). No. of bitstreams: 2 license.txt: 1748 bytes, checksum: 8a4605be74aa9ea9d79846c1fba20a33 (MD5) 1291.pdf: 1062166 bytes, checksum: f9a5c964726f24cc4d45694a3bdb1763 (MD5) Previous issue date: 1994 / O objetivo deste trabalho foi analisar a tendência e o perfil epidemiológico da mortalidade materna no município do Rio de janeiro e nas suas áreas de planejamento no período de 1960 a 1990 e subsidiar o planejamento de ações de assistência a saúde reprodutiva feminina. As fontes de dados foram as publicações e listagens da Secretaria de Estado de Saúde no período de 1960-1978 e o Sistema de Informação de Mortalidade do Ministério de Saúde, de 1979 em diante. Os dados sobre nascidos vivos procedem dos Anuários estatísticos e das estatísticas do Registros Civil do IBGE. As analises foram realizadas agrupando-se os dados em períodos quinquenais. Resultado Destaca-se a queda de 70% da mortalidade materna que passou de 180,14 para 52,41 óbitos maternos por 100.000 nascidos vivos(nv), considerando todo o período de 30 anos. Nossas taxas de mortalidade mesmo sem correção da subnotificação e do subregistro, encontram-se em patamares semelhantes aos dos países desenvolvido nas década de 50/60. Observou-se também uma mudança no perfil de causas. No início da década de 60,as hemorragias que ocupavam o primeiro lugar, hoje correspondem a terceira causa mais frequente. Atualmente, a principal causa de morte materna é a toxemia, seguida das complicações puerperais. Ao desagregarmos as taxas do município por áreas de residência, a Área de Planejamento 2 (AP2), de maior poder aquisitivo, apresentou a menor taxa média do período, 60,34 óbitos maternos por 100.000 nv. A maior taxa foi registrada na AP1 , que reúne as regiões administrativas do Centro e área Portuária e deve-se provavelmente a invasão de óbitos de outras regiões e municípios. Notou-se ainda uma maior mortalidade nas faixas etárias extremas. Discutiu-se também o impacto da queda da fecundidade na mortalidade materna. / The objective of this study was to analyze trends and epidemiological profile of maternal mortality in the municipality of Rio de Janeiro and sub-areas in the period 1960-1990 and contribute to planning the assistance to women's reproductive health. Data sources were the publications and list of the Secretary of State for Health in the period 1960-1978 and the Mortality Data System of the Ministry of Health, from 1979 onwards. Live births data were from the Annual Report of Statistics and Civil records of IBGE. Analyses were performed by grouping the data into five-year periods. Results The study highlights the decline of 70% of maternal mortality, which increased from 180.14 to 52.41 deaths per 100,000 live births (lb), considering the whole period of 30 years. Our mortality rates, even without correction of underreporting, are similar to developed countries in the decade of 50/60. We also noticed a change in the profile of causes. In the early 60's, hemorrhage that occupied the first cause, now represent the third most frequent cause. Currently, the leading cause of maternal death is toxemia, followed by puerperal complications. When we analyzed rates by area of residence, Planning Area 2 (AP2), that had the highest social- economic level, had the lowest mean mortality rate for the period, 60.34 deaths per 100,000 live births. The highest rate was observed in AP1, corresponding to the administrative regions of Central and Harbour area and is happened probably due to invasion of deaths from other regions and municipalities. It was noted a higher mortality even in extreme ages. It was also discussed the fertility impact in maternal mortality reduction.

Made available in DSpace on 2014-06-11T19:35:14Z (GMT). No. of bitstreams: 0 Previous issue date: 2008-06-26Bitstream added on 2014-06-13T20:26:24Z : No. of bitstreams: 1 sakamoto_dl_dr_fran.pdf: 859409 bytes, checksum: 7fb448c4c503117bdd0ed371c6d0a9ba (MD5) / Discutir a questão da saúde sexual e reprodutiva de jovens que tiveram filhos na adolescência postulou o enfoque deste estudo, entendendo que a necessidade do envolvimento dos sistemas de proteção social torna-se fundamental para a saúde integral. Pouco se tem estudado a respeito da proteção dessa jovem mulher, a constituição familiar, os processos de reorganização de suas famílias de origem, bem como o papel das políticas públicas nesses contextos. O quadro teórico está fundamentado nos estudos sobre a prevenção e promoção da saúde do MS, OMS, OPAS, PNAD, IBGE e Política Municipal de Saúde e em bases conceituais de Goldani, Machado, Lopes, Rubiol e Bracho entre outros. Participaram do estudo nove sujeitos, dois coordenadores de programas de atenção à saúde de crianças e adolescentes e sete jovens mães usuárias do Sistema Único de Saúde (SUS). A partir de abordagem qualitativa, utilizou-se a entrevista como instrumento de coleta de dados, realizada na Secretaria Municipal de Saúde e Unimed de Ribeirão Preto, SP, e nos domicílios das jovens mães. Os dados foram analisados e agrupados ao redor de temas: saúde e educação de crianças e adolescentes e a realidade no cenário público e privado, vivências de jovens mulheres, o cotidiano familiar e social, sentimentos e significados experimentados pela maternidade, aspectos sexuais e reprodutivos, prevenção e promoção da saúde. As experiências de mães e profissionais retratam a importância dos cuidados com a saúde sexual e reprodutiva, embora a atenção voltada à educação e saúde para essas jovens mães esteja muito aquém da realidade dos programas estudados. Os mesmos se desenvolvem a partir de metas pré-estabelecidas e, segundo análise de conteúdo expressa pelas jovens, essas já não freqüentam mais os bancos escolares, e não estão inseridas nos programas de saúde... / The discussion of sexual and reproductive health in youngsters who have given birth during adolescence has postulated the emphasis of this study, assuming that the involvement of the social protection systems is fundamental for integral health. Little has been researched and studied about these young women, their family constitution, procedures for reorganizing their original families, and the role of public policies within these contexts. The theory is founded on the basis of studies aimed at health promotion and prevention of the Brazilian Ministry of Health, OMS (World Health Organization), OPAS, PNAD, IBGE (Brazilian Institute of Geography and Statistics), City Health Policies, and basic concepts by Goldani, Machado, Lopes, Rubiol and Bracho, amongst others. Nine subjects, two coordinators of programs attending to children and adolescent health, and seven young mothers depending on the Sistema Único de Saúde (SUS) (Unified Health System) have taken part in this study. Using the qualitative approach, interviews were the main resource to collect information, and were performed at the City Health Office and Unimed, in the city of Ribeirão Preto, SP, and at the residence of the subjected young mothers. The data collected was analyzed and classified according to the following themes: children and adolescents health and education and the reality of the public and private scopes; young women life experiences; family and social daily life; feelings experienced due to maternity; sexual and reproductive aspects; prevention and health promotion. Such experiences as described by the mothers and professionals reiterate the importance of sexual and reproductive health care, albeit the attention given to these young mothers concerning health and education is highly lacking when compared to the reality of the social programs studied...(Complete abstract, click electronic access below)

Este trabalho se inscreve no campo dos estudos sobre sexualidade e práticas reprodutivas e contraceptivas, no contexto do Município de Porto Alegre onde muito recentemente passou a ser disponibilizado, na rede pública de saúde, um novo método contraceptivo, o implante subcutâneo Implanon. Partindo de um caso específico de implementação de uma ação governamental na área de saúde reprodutiva, este estudo tem como objetivo compreender, a partir de uma perspectiva antropológica, os significados da prática contraceptiva de implantes subcutâneos para as jovens residentes na região geográfica da cidade, a Restinga e seu entorno, que foi alvo privilegiado desta intervenção pública. Como pano de fundo descreve-se e apresenta-se o processo de idealização, implementação e debate em torno desta política de saúde, assim como o conjunto de atores e agencia que participaram do mesmo. Com a finalidade de conhecer o universo cultural das mulheres que optaram pela tecnologia contraceptiva oferecida pela política municipal, analisam-se as práticas sexuais, reprodutivas e contraceptivas das mulheres entrevistadas, evidenciando algumas categorias e valores imputados a estas práticas e experiências. Discutem-se, a partir do contexto específico pesquisado, os significados e o universo de relações onde se dá a prática contraceptiva de implantes subcutâneos. Enfatiza-se, nesta parte final, como é que tal prática contraceptiva se conecta com as relações afetivo-sexuais, contraceptivas e reprodutivas. A partir desta contextualização foi possível perceber que os eventos envolvidos no processo de gestar e evitar gravidez pode significar e gerar diferentes consequências para os sujeitos neles envolvidos. Igualmente, a abordagem centrada nas especificidades do grupo social "alvo" da ação governamental, evidenciou as diferentes perspectivas e apropriações desta política municipal. / Situated within the field of studies on sexuality and reproductive and contraceptive practices, this study takes as its context the municipality of Porto Alegre, where a new contraceptive method - the subcutaneous implant, Implanon - was recently made available through the public health system. Departing from a specific case of the implementation of a governmental action in reproductive health, the objective of this study is to understand, from an anthropological perspective, what the contraceptive implants mean for young female residents of a particular area of the city - Restinga and its surroundings - that was a target of this public intervention. As background, the process of the health policy's formulation and implementation, and the subsequent debates regarding it, is described, and the collection of participating actors and agencies is presented. With the aim of becoming familiar with the cultural universe of the women who opted for the contraceptive technology proffered by the municipal policy, the sexual, reproductive, and contraceptive practices of interviewed women are analyzed; these data bring to light some of the categories and values ascribed to aforesaid practices and experiences. The meanings and the universe of relationships in which the contraceptive practice of the implants takes place is discussed with specific reference to the research context. The last section emphasizes how such contraceptive practices connect with affective-sexual, contraceptive and reproductive relationships. Through contextualization, it is possible to perceive that the process of both becoming pregnant and avoiding becoming pregnant can mean different things and generate diverse consequences for the subjects involved. Likewise, an approach focused on the specificities of the target population of this governmental action makes plain the different perspectives on and appropriations of municipal policy.

Made available in DSpace on 2014-12-17T14:13:32Z (GMT). No. of bitstreams: 1 CarmenOMM.pdf: 496226 bytes, checksum: ffe8d9f5c4aeefe21f32ca1fb1b212d5 (MD5) Previous issue date: 2007-08-30 / Conselho Nacional de Desenvolvimento Cient?fico e Tecnol?gico / Institutional violence ranges from the most widespread lack of access to the poor quality of services provided. It includes abuses committed by virtue of the unequal power between patients and professionals within institutions. The aim of this study was to analyze the perception of women with regard to this type of violence, in the services offered at a reproductive health facility belonging to the National Health System (SUS) in Natal, Brazil. Interdisciplinary perspective is important, in that it provides interaction and complementarity between various disciplines, favoring, in an integrated way, a thematic approach in research activities, teaching and extension, involving professionals, students and researchers in medicine, social services, psychology, nursing, anthropology and physical therapy. A quantitative/qualitative approach was used, involving a sample of 401 women, as part of a transversal observational study. In the qualitative stage, which consisted of participatory observation and semi-structured interviews, we used an intentional sample of 10 individuals. The data were analyzed using logistic regression techniques, correspondence analysis and categorical thematic content analysis, showing that the 2 questions that investigated directly the perception of institutional violence obtained affirmative response frequencies of 28.2% and 31.8%, respectively. In regard to data collected in a field diary related to participatory observation, the main complaints referred to the health providerpatient relation, translated into dissatisfaction with the interpersonal relationship and with the resolution of the specific demand that required care. From content analysis, we classified 4 categories: Access; Information; Health professionalpatient relation; and Respect/dignity. We identified 6 subcategories: Impossibility of choice; Repressed demand; Communication difficulty; Asymmetric interpersonal relations; Privacy/confidentiality; Disrespect. We concluded, therefore, that the data presented show that in the reproductive health care programs, there are indicators of institutional violence. However, it is difficult to approach this phenomenon, mainly because of the power relations involved in the patient-health care provider interaction, resulting from unawareness that determinate situations violate sexual and reproductive rights. This can be explained by sociostructural questions that reveal marked inequalities, ratified by issues related to violation of the rights of National Health System (SUS) patients / A viol?ncia institucional pode incluir desde a dimens?o mais ampla da falta de acesso ? m? qualidade dos servi?os oferecidos. Abrange abusos cometidos em virtude das rela??es de poder desiguais entre usu?rios(as) e profissionais dentro das institui??es. Esta pesquisa objetiva analisar a percep??o das mulheres em rela??o ? ocorr?ncia deste tipo de viol?ncia no cotidiano dos servi?os de refer?ncia em sa?de reprodutiva, no ?mbito do Sistema ?nico de Sa?de (SUS), na cidade de Natal/ RN. ? pertinente ? perspectiva interdisciplinar, na medida em que proporciona intera??o e complementaridade entre v?rias disciplinas, favorecendo, de forma integrada, a abordagem da tem?tica em atividades de pesquisa, ensino e extens?o. Foi realizado estudo transversal envolvendo amostra de 401 mulheres e abordagem qualitativa com amostra intencional de dez participantes, a qual constou de observa??o participante e entrevistas semi-estruturadas. Os dados foram analisados atrav?s das t?cnicas de regress?o log?stica, an?lise de correspond?ncia e an?lise de conte?do tem?tica categorial.As quest?es que investigaram diretamente a percep??o da viol?ncia institucional obtiveram freq??ncias de respostas afirmativas de 28,2% e 31,8%. Para o c?lculo da amostragem, foi utilizado poder de 80% e alfa de 5% A partir da observa??o participante, foi poss?vel vivenciar que as principais queixas referiram-se ? rela??o entre provedores de sa?de e usu?rias, traduzindo-se numa insatisfa??o quanto ? forma de relacionamento interpessoal e ? resolutividade em rela??o ? demanda espec?fica que motivou o atendimento. Quanto ? an?lise de conte?do, a partir do processo de categoriza??o, destacaram-se 4 categorias: acesso; informa??o; rela??o usu?rias/profissionais de sa?de; e respeito/ dignidade. Foram identificadas seis subcategorias: impossibilidade de escolha; demanda reprimida; dificuldade de comunica??o; rela??es interpessoais assim?tricas; privacidade/confidencialidade; Desrespeito. Pode-se concluir que os resultados apontam para exist?ncia de indicadores de viol?ncia institucional no cotidiano dos programas de aten??o ? sa?de reprodutiva; no entanto, revela-se a dificuldade de abordagem desse fen?meno, principalmente devido ?s rela??es de poder envolvidas na intera??o usu?rias/ provedores, decorrentes do n?o reconhecimento de determinadas situa??es como violadoras dos direitos sexuais e reprodutivos. Esses aspectos remetem, portanto, a quest?es socioestruturais que traduzem marcantes desigualdades, ratificadas por quest?es pertinentes ? viola??o dos direitos das usu?rias no ?mbito do SUS

Kvinnor har rätt till informerat samtycke och informerade val när det gäller undersökningar och behandlingar under graviditet och förlossning både utifrån FNs mänskliga rättigheter och utifrån svensk lagstiftning. Kvinnan har historiskt befunnit sig långt ned i den hierarkiska ordningen inom förlossningsvården. Det råder en riskkultur i det västerländska moderna samhället som även märks av i vården av gravida och födande kvinnor. Kvinnor genomgår många olika undersökningar och behandlingar under graviditet och förlossning av vilka några har oklar evidens. Barnmorskan har en viktig roll i att ge kvinnor möjlighet till informerat samtycke och informerade val när det gäller undersökningar och behandlingar under graviditet och förlossning. Det behövs mer kunskap om hur kvinnor i Sverige ges möjlighet till detta. Syftet med studien är att undersöka om kvinnor ges möjlighet till informerat samtycke och informerade val när det gäller undersökningar och behandlingar under graviditet och förlossning. Studien utfördes som en kvantitativ tvärsnittsstudie och datainsamlingen gjordes med hjälp av enkäter. Det insamlade materialet analyserades med både deskriptiv och analytisk statistik. Resultatet antyder att kvinnor inte ges möjlighet till informerat samtycke och informerade val utifrån begreppens rätta bemärkelse när det gäller ett flertal specifika undersökningar och behandlingar under graviditet och förlossning förutom när det gäller rutinultraljudsundersökningen. Kvinnor uppfattar dock att de ges möjlighet vara delaktiga i beslut rörande undersökningar och behandlingar överlag under graviditet och förlossning. Hierarkiska ordningar och riskkulturen som råder i förlossningsvården är tidigare påvisade faktorer som kan utgöra hinder för kvinnors möjligheter till informerat samtycke och informerade val under graviditet och förlossning. Med en vård baserad på ett patientperspektiv kan kvinnors ställning samt autonomi stärkas. För en hållbar utveckling är kvinnors möjligheter at t göra informerade val angående sin sexuella och reproduktiva hälsa avgörande. / Women have the right to informed consent and informed choice with regard to examinations and treatment during pregnancy and childbirth on the basis of the human rights conducted by The United Nations, and according to Swedish law. Women have historically been far down in the hierarchical order in the birthing care system. There is a risk culture in Western modern society that is also noticeable in the care of pregnant women and women giving birth. Women undergo a variety of examinations and treatments during pregnancy and childbirth, some of which have unclear evidence. The midwife has an important role to give women the opportunity for informed consent and informed choices regarding examinations and treatments during pregnancy and childbirth. There is a need for more knowledge about how women in Sweden are given the opportunity to do so. The aim of the study is to investigate whether women are given the opportunity for informed consent and informed choices with regard to examinations and treatments during pregnancy and childbirth. The study was conducted as a quantitative cross-sectional study and questionnaires were used for data collection. The collected data was analysed with both descriptive and analytical statistics. The results suggest that women are not given opportunities for informed consent and informed choices based on their true sense when it comes to several specific examinations and treatments during pregnancy and childbirth except for the routine ultrasound examination. Nevertheless do women perceive that they are given opportunities to participate in decision making regarding examinations and treatments in general during pregnancy and childbirth. Hierarchical schemes and risk culture that prevails in the birthing care system is earlier identified factors that may pose obstacles to women's opportunities for informed consent and informed choice during pregnancy and childbirth. Through a care based on a patient perspective, the status of women and women's autonomy would be strengthened. For sustainable development, women's opportunities to make informed choices about their sexual and reproductive health are crucial.

Introdução: A mortalidade materna é um grande problema de Saúde Pública no Brasil e no mundo. Atinge muitas mulheres e representa um indicador de pobreza e iniquidade social. Objetivo: Analisar as mortes maternas ocorridas no município de São Paulo em uma série histórica de 2000 a 2008. Métodos: Estudo ecológico, que analisou os óbitos maternos ocorridos em residentes do município de São Paulo entre os anos de 2000 a 2008. Foram utilizados dados das Declarações de Óbito e dos relatórios do Comitê de Mortalidade Materna. O mapa de exclusão/inclusão social e as áreas homogêneas dos 96 distritos administrativos foram utilizados como unidades de análise. Foram calculadas as razões de mortalidade materna, o percentual de subnotificação de causas maternas declaradas e fator de correção. Foram analisadas as causas que ocultavam os óbitos maternos. A análise de tendência da mortalidade para o município foi realizada por meio de modelos de regressão polinomial e a para análise de correlação utilizou-se o teste de correlação de Pearson. Foi considerado o nível de significância de 5 por cento (p<0,05). Para análise do preenchimento das variáveis 43 e 44, as Declarações de óbito foram localizadas no arquivo morto da Prefeitura Municipal. Resultados: Ocorreram 877 óbitos. A Razão de Mortalidade Materna (RMM) foi de 53,2 óbitos/100.000 Nascidos Vivos. A série histórica apresentou tendência decrescente estatisticamente significativa, com redução de 1,73 ao ano. As menores RMM foram encontradas nas áreas homogêneas de menor exclusão social, e as maiores, nas áreas de maior exclusão. As áreas mais excluídas apresentaram risco de morte materna aproximadamente três vezes maior que na área menos excluída. A correlação de Pearson revelou moderada correlação negativa entre a RMM e o índice de exclusão/inclusão global (-0,37), o índice de desenvolvimento humano (-0,40) e de autonomia (-0,36). As principais causas de morte materna foram as obstétricas indiretas. O percentual médio de subnotificação das causas maternas foi de 45,38 por cento, e o fator de correção médio foi 1,83. Destacou-se o grande percentual de causas mal definidas declaradas. Entre 2004 a 2006, 43,4 por cento das declarações apresentaram os campos 43 e 44 preenchidos corretamente. A maioria das declarações apresentou três diagnósticos informados. Conclusões: A RMM mostrou relação com as condições socioeconômicas. É necessário maior investimento em treinamentos para o correto preenchimento das Declarações de óbito. É necessário a implementação mais efetiva de ações de saúde voltadas para a mortalidade materna / Background: Maternal mortality is a big problem of public health in Brazil and in the world. Affects many women and is an indicator of poverty and social inequity. Objective: To analyse maternal deaths occurred in the city of São Paulo in a series from 2000 to 2008. Methods: Ecologic study, which analyzed maternal deaths that occurred among residents of city of São Paulo during the years 2000 to 2008. Data were used from deaths certificates and reports of the Committee on Maternal Mortality. The map of social inclusion/exclusion and homogeneous areas of the 96 districts were used as units of analysis. We calculated maternal mortality ratios, the percentage of underreporting of maternal causes and the correction factor. We analyzed the causes that hid maternal deaths. The analysis of trends in mortality for the city was conducted using polynomial regression models and for correlation analysis used the test of correlation of Pearson. It was considered the significance level of 5 per cent (p<0,05). For examination of completing the variables 43 and 44, the deaths certificates were located in the archive of the city. Results: There were 877 deaths. The Maternal Mortality Ratio (MMR) was 53,2/100.000 live births. The series showed trend decreasing statistically significant, with a decrease of 1,73 per year. The lower MMR were found in homogeneous areas with lower social exclusion and higher than areas with higher exclusion. Areas most excluded showed risk of maternal deaths about three times higher than in area less excluded. The correlation of Pearson showed moderate negative correlation between MMR and index inclusion/exclusion overall (-0,37), the index of human development (-0,40) and the index of autonomy (-0,36). The main causes of maternal deaths were obstetric indirect. The mean percentage of underreporting of maternal causes was 45,38 per cent , and the correction factor medium was 1,83. We emphasize the high percentage of illdefined causes declared. During 2004 and 2006, 43,4 per cent of the declarations presented fields 43 and 44 filled in correctly. Most declarations presented three diagnoses listed. Conclusion: The MMR showed relationship with socioeconomic conditions. It is necessary greater investment in training for correct completion of death certificates. It is necessary the implementation more effective heath actions to maternal mortality

Este trabalho se inscreve no campo dos estudos sobre sexualidade e práticas reprodutivas e contraceptivas, no contexto do Município de Porto Alegre onde muito recentemente passou a ser disponibilizado, na rede pública de saúde, um novo método contraceptivo, o implante subcutâneo Implanon. Partindo de um caso específico de implementação de uma ação governamental na área de saúde reprodutiva, este estudo tem como objetivo compreender, a partir de uma perspectiva antropológica, os significados da prática contraceptiva de implantes subcutâneos para as jovens residentes na região geográfica da cidade, a Restinga e seu entorno, que foi alvo privilegiado desta intervenção pública. Como pano de fundo descreve-se e apresenta-se o processo de idealização, implementação e debate em torno desta política de saúde, assim como o conjunto de atores e agencia que participaram do mesmo. Com a finalidade de conhecer o universo cultural das mulheres que optaram pela tecnologia contraceptiva oferecida pela política municipal, analisam-se as práticas sexuais, reprodutivas e contraceptivas das mulheres entrevistadas, evidenciando algumas categorias e valores imputados a estas práticas e experiências. Discutem-se, a partir do contexto específico pesquisado, os significados e o universo de relações onde se dá a prática contraceptiva de implantes subcutâneos. Enfatiza-se, nesta parte final, como é que tal prática contraceptiva se conecta com as relações afetivo-sexuais, contraceptivas e reprodutivas. A partir desta contextualização foi possível perceber que os eventos envolvidos no processo de gestar e evitar gravidez pode significar e gerar diferentes consequências para os sujeitos neles envolvidos. Igualmente, a abordagem centrada nas especificidades do grupo social "alvo" da ação governamental, evidenciou as diferentes perspectivas e apropriações desta política municipal. / Situated within the field of studies on sexuality and reproductive and contraceptive practices, this study takes as its context the municipality of Porto Alegre, where a new contraceptive method - the subcutaneous implant, Implanon - was recently made available through the public health system. Departing from a specific case of the implementation of a governmental action in reproductive health, the objective of this study is to understand, from an anthropological perspective, what the contraceptive implants mean for young female residents of a particular area of the city - Restinga and its surroundings - that was a target of this public intervention. As background, the process of the health policy's formulation and implementation, and the subsequent debates regarding it, is described, and the collection of participating actors and agencies is presented. With the aim of becoming familiar with the cultural universe of the women who opted for the contraceptive technology proffered by the municipal policy, the sexual, reproductive, and contraceptive practices of interviewed women are analyzed; these data bring to light some of the categories and values ascribed to aforesaid practices and experiences. The meanings and the universe of relationships in which the contraceptive practice of the implants takes place is discussed with specific reference to the research context. The last section emphasizes how such contraceptive practices connect with affective-sexual, contraceptive and reproductive relationships. Through contextualization, it is possible to perceive that the process of both becoming pregnant and avoiding becoming pregnant can mean different things and generate diverse consequences for the subjects involved. Likewise, an approach focused on the specificities of the target population of this governmental action makes plain the different perspectives on and appropriations of municipal policy.

Do people’s attitudes towards female genital cutting (FGC) change after they migrate from a country where the practice is common, to one where it is not? Alongside increased levels of migration, this question is increasingly being raised. This thesis aimed to expand the understanding about attitudes towards FGC held by Somali men and women in Sweden, and thereby to identify potential factors that impede or facilitate the cessation of FGC. Cross-sectional questionnaire data were collected in four Swedish municipalities to assess attitudes to FGC. To further explore perceptions of FGC, as well as the circumcision of boys, semi-structured interviews and focus group discussions were conducted. Data were collected in 2015. The findings identified an overall widespread opposition to forms of FGC that cause anatomical change. A majority (78%) expressed an opposition to the continuation of all forms of FGC, with the odds of supporting FGC decreasing with increased years of residency in Sweden. An identified 18% reported a support for the continuation of pricking (FGC type IV). A support of pricking was linked with perceiving it as acceptable according to Islam, not a violation of children’s rights, and not causing long-term health complications. Pricking was not defined as a form of FGC by 32%. Most men described a preference to marry an uncircumcised woman (76%) or one who had had pricking (16%). How the individuals perceived the support of FGC in the Swedish Somali community corresponded well with their own approval of the practice. While there seemed to be a continuity regarding the Swedish Somalis’ core values of being a good Muslim, not inflicting harm, and upholding respectability, re-evaluation of how these are applied when it comes to circumcision of girls and boys was identified. This resulted in FGC being viewed as a practice that could be abandoned or adapted. Paradoxically, based on the same core values, the circumcision of boys was continuously perceived as an unquestionable required practice. Altogether, these results suggest that a shift in convention towards no FGC is taking place. However, the identified lack of consensus on practices regarded as FGC needs further attention.