Skip to main content

Currently Skimming:


Pages 20-39

The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.


From page 20...
... 20 REPRODUCTIVE HEALTH IN DEVELOPING COUNTRIES 20 2 Healthy Sexuality We use the term "healthy sexuality" to incorporate a sense of volitionin sexual relations and control over one's body. Sexual autonomy is thus part of healthy sexuality, if choices are informed and responsible.
From page 21...
... HEALTHY SEXUALITY 21 cultural variation in sexual norms and practices and in the social meaning of healthy sexuality. We identify three different aspects of sexuality over which individual control is possible and on which there would be varying levels of agreement with regard to autonomy: (1)
From page 22...
... 22 REPRODUCTIVE HEALTH IN DEVELOPING COUNTRIES The third condition is a topic of much disagreement. Though the concept of rape of a spouse has been defined under legal codes in some areas, husbands have been considered to have a right to sexual relationships with their wives in most cultures, though in virtually no culture is this right unconditional in principle, even if it is sometimes in practice.
From page 23...
... HEALTHY SEXUALITY 23 T A B L E 2 -1 M en a nd W om en A ge d 1 549 R ep or ti ng O ne o r M or e N on re gu la r Se xu al P ar tn er s in L as t 12 M on th s, by C u rr en t M ar it al S ta tu s: i n pe rc en t M en W om en C u rr en tl y Fo rm er ly N ev er C u rr en tl y Fo rm er ly N ev er C ou n tr y or C it y M ar ri ed M ar ri ed M ar ri ed M ar ri ed M ar ri ed M ar ri ed A fr ic a B u ru n d i 8 6 6 3 0 0 C en tr al A fr ic an R ep u bl ic 14 12 14 4 11 4 C ôt e d 'I vo ir e 49 61 54 10 38 29 G u in ea B is sa u 42 49 49 19 7 28 K en ya 21 75 44 3 35 32 L es ot h o 46 55 36 19 21 14 L u sa ka 35 46 35 10 15 8 T an za n ia 21 64 49 7 43 28 T og o 21 8 17 2 0 1 A si a M an il a 8 20 23 1 5 1 Si n ga p or e 6 40 13 0 8 0 Sr i L an ka 5 11 3 3 18 1 T h ai la n d 17 59 45 1 14 1 So u th A m er ic a R io d e Ja n ei ro 31 91 69 5 34 17 SO U R C E : A d ap te d f ro m C ar aë l (1 99 5)
From page 24...
... 24 REPRODUCTIVE HEALTH IN DEVELOPING COUNTRIES married and even currently married men report higher rates than do single men. Many Africans consider it legitimate for a man to have sexual access to cowives, mistresses, or commercial sex workers during any particular wife's postpartum period.
From page 25...
... HEALTHY SEXUALITY 25 control over the frequency or intensity of sexual activity. But numbers reveal little about motives; one cannot infer women's levels of autonomy from high or low levels of premarital sexual activity.
From page 26...
... 26 REPRODUCTIVE HEALTH IN DEVELOPING COUNTRIES sally weaker and less strictly enforced than prohibitions against female sexual activity before marriage. Condonement, and even encouragement, of sexual experience by young men affects the reproductive health of both men and women.
From page 27...
... HEALTHY SEXUALITY 27 reproductive tract problems. Many popular magazine or newspaper columns on health-related matters include letters from readers that refer to female reproductive tract problems for which the letter writers are embarrassed to seek medical help (see, e.g., Basnayake, 1985)
From page 28...
... 28 REPRODUCTIVE HEALTH IN DEVELOPING COUNTRIES often to women's sexual greed or wantonness that makes them neglect home and family in the search for lovers and to the need to control this tendency (see, e.g., Constantinides, 1985)
From page 29...
... HEALTHY SEXUALITY 29 The second reason is the increasing "sexualization" of cultures worldwide (see, e.g., Udry, 1993; Burt, 1990)
From page 30...
... 30 REPRODUCTIVE HEALTH IN DEVELOPING COUNTRIES "autonomy" can have little positive meaning for women (or men) who feel forced to sell sexual services.
From page 31...
... HEALTHY SEXUALITY 31 Gender-based violence has an obvious impact on women's control over their sexuality and therefore their sexual health. The negative consequences of violence that have a direct bearing on reproductive health include physical injuries, STDs, pelvic inflammatory disease, unwanted pregnancy, and unsafe abortion or miscarriage -- as well the mental or psychological aspects of sexuality, such as depression, anxiety, and sexual dysfunction (Jenny et al., 1990; Koss, Heise, and Russo, 1994)
From page 32...
... 32 REPRODUCTIVE HEALTH IN DEVELOPING COUNTRIES One particular kind of sexual coercion deserves separate mention, the sexual exploitation of young children. The consequences of this form of coercion are likely to be even more traumatic and long-lasting than those of violence against adult women.
From page 33...
... HEALTHY SEXUALITY 33 the removal of the entire clitoris, both prepuce and glans, and may include the removal of the adjacent labia, either minora, majora, or both. Sunna circumcision and excision affect 85 percent of the women who have undergone genital mutilation (World Health Organization, 1994)
From page 34...
... 34 REPRODUCTIVE HEALTH IN DEVELOPING COUNTRIES POLICY AND PROGRAM IMPLICATIONS Policies and programs to promote healthy sexuality on the dimensions of freedom from violence, the right to refuse unwanted sexual relations, and the ability to seek to express and to enjoy one's sexuality can be divided into three broad types: policies and programs that increase the information and knowledge base needed to promote reproductive health, including the need to collect more information, as well as the need to disseminate such information to those who need and can use it; policies and programs that provide individuals the means to achieve such healthy sexuality; and policies and programs that provide the social, legal, and community support needed to prevent sexual violence as well as to protect and treat the victims of such violence. Culturally appropriate interventions are needed at a variety of levels: social and political structures, norms, communities, families, couples, and individuals.
From page 35...
... HEALTHY SEXUALITY 35 cion, the sexual exploitation of children, and female genital mutilation, and the forms they take in particular societies. Research is also needed on the meaning of female genital mutilation for women and its consequences for health in the communities in which it is practiced.
From page 36...
... 36 REPRODUCTIVE HEALTH IN DEVELOPING COUNTRIES by nongovernmental organizations (International Planned Parenthood Federation, 1995)
From page 37...
... HEALTHY SEXUALITY 37 practice specific skills and to increase young people's confidence in their skills. We have not found evaluations dealing specifically with the influences of sexuality education on attitudes and behavior related to violence and sexual coercion.
From page 38...
... 38 REPRODUCTIVE HEALTH IN DEVELOPING COUNTRIES awareness of family planning, which may lead to positive behavior changes. Television and radio are widely accessible and influential, particularly among young people.
From page 39...
... HEALTHY SEXUALITY 39 Legal and Policy Changes Legal and policy changes to promote healthy sexuality can include reform of laws related to sexual and domestic violence, policies that include sexuality education in public schools, reform of family laws to increase the rights of women to property and inheritance, and enforcement of laws against cultural practices harmful to reproductive health (such as female genital mutilation)

Key Terms



This material may be derived from roughly machine-read images, and so is provided only to facilitate research.
More information on Chapter Skim is available.