Training of Roma Health Mediators in Reproductive Health

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SESSION 11: INFERTILITY OBJECTIVES: By the end of the session, the participants should be able to: 1. Name common causes of infertility 2. Describe general measures for reducing the risks of infertility and for investigation of a infertile couple TRAINING METHODS: Discussion, Presentation TIME: 30 minutes MATERIALS: Trainer document • Causes of Infertility INSTRUCTIONS: I. INFERTILITY – DEFINITION, CAUSES (15 minutes) Refer to the last session and the fact that untreated STIs can lead to problems of infertility. Ask participants: ‣ When you hear someone say that a man, or a woman or a couple is infertile, what do you think that means? That the person, or couple, has difficulty having (or is unable to have) a child. ‣ In general, who is responsible for not being able to have a pregnancy/a child? Either the man or the woman, or both of them, may be unable to do their part in order to create a pregnancy/have a child. Explain that: • Often the woman is blamed when she does not become pregnant. Even if the couple gets medical help, sometimes doctors will check only the woman for fertility problems. But just as often the man is the one who is infertile. Neither men nor women should be blamed for infertility. And both need support during this difficult time. For a couple that wants to have children, infertility can bring sadness, anger, or shame. • A couple is said to be infertile if the woman has not gotten pregnant after having normal sexual intercourse two-three times a week, without using any method of contraception, for at least one year. In general, 80% of couples who are trying to have a baby can achieve a pregnancy within a year, and up to 90% within 18 months of trying. • Infertility has many causes. Some causes of infertility are preventable. 176 RFHI/JSI Romania Training of RHMs in Reproductive Health Session 11: Infertility
o Sexually transmitted infections can leave scars inside a man’s or woman’s reproductive parts that prevent pregnancy from occurring. o Illnesses such as diabetes, tuberculosis, and mumps can cause infertility. o Dangerous chemicals from pesticides, cleaning products, or factories can get into the air, water, or food. These chemicals can make it difficult for a woman to get pregnant, or can harm the growing baby. o Smoking, drinking a lot of alcohol or using drugs can all harm fertility. o There are other causes of infertility that are not preventable. Make a short presentation of the causes of infertility, using the trainer document Causes of Infertility as a basis. Emphasize that infertility is a problem involving two people. On average, the cause lies with the man 40% of the time and with the woman 40% of the time; and in 20% of the cases, both man and woman contribute to the problem. II. REDUCING THE RISK OF INFERTILITY (15 minutes) Ask participants: ‣ What health practices do people need to follow to protect their own fertility and general health? • Maintain good health by eating nutritious meals, keeping good personal hygiene, and getting sufficient sleep. • Avoid behaviors that can harm physical and mental health like drugs, alcohol, excess stress, or violence. • Know and watch for the signs of a possible reproductive health problem. (These signs may include pain or burning with urination, unusual discharge or smell from the penis or vagina, pain during sexual intercourse or sores, rashes, itching, burning or pain around the genital area) • Seek health and other services for regular checkups. Also seek services if an unusual change is noticed, or you have questions or concerns. • Follow recommended treatment, if prescribed. ‣ What are the general investigations for infertility? • Monitor the signs of ovulation (cervical secretion, basal body temperature) • Physical exam for both partners • Semen analysis • Other investigations for checking woman’s fertility (tubal permeability, uterine structure) ‣ What can mediators do to help people to reduce the risk of, or to face, infertility problems? Mediators can discuss with people common causes of fertility problems and risk 177 RFHI/JSI Romania Training of RHMs in Reproductive Health Session 11: Infertility
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Romanian Family Health Initiative A
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2005 - JSI Research & Training Inst
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INTRODUCTION JSI Research and Train
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Acknowledgements This manual was de
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SESSION 1: INTRODUCTION OBJECTIVES:
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Common group norms: • Respect the
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Flip chart/ Participant document TR
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Participant document HEALTH MEDIATO
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Matching questions Below are two li
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Multiple Choice Questions Each of t
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SESSION 2: BASIC CONCEPTS OF REPROD
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Possible Answers: • Not to have c
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‣ How many children do you have?
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an important effect on reducing mat
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Trainer document FAMILY PLANNING De
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Trainer document THE RIGHTS OF THE
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Trainer document RELATIONSHIP BETWE
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(HOLD THE THIRD/SMALLEST SIGN IN FR
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SESSION 3: ANATOMY AND PHYSIOLOGY O
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• What is menstruation? • What
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Trainer document MALE REPRODUCTIVE
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lining like a pillow. If the girl/w
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Participant document 36 RFHI/JSI Ro
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Participant document 38 RFHI/JSI Ro
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Participant document MALE AND FEMAL
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‣ What do the terms “conception
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‣ What are the situations in whic
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During the exercise move around the
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Distribute the participant document
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Emphasize that although insertion o
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SUMMARY At the end of this session,
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Flipchart FAMILY PLANNING METHODS N
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FERTILITY AWARENESS METHODS Fertili
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Trainer document STEPS FOR CONDOM U
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Correct Use of Condom • Check the
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9. Explain the importance of withdr
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Trainer document COMBINED ORAL CONT
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Trainer document PROGESTAGEN-ONLY P
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Trainer document INTRA-UTERINE DEVI
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Trainer document VOLUNTARY SURGICAL
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Myths and Facts about Vasectomy Myt
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Male Condom Show the client the con
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Progestagen-Only Pills (POPs) Show
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Intrauterine Device (IUD) Show the
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Emergency Contraception Pills (ECPs
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Using the trainer’s document Stan
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• When do you expect your next pe
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Participant document CASE STUDIES (
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Trainer document CASE STUDIES (answ
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Participant document The majority o
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Participant document HOW TO USE “
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6. If she recently had a miscarriag
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Participant document FREQUENT ASKED
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Recommended question: - Are you and
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SESSION 6: SAFE MOTHERHOOD - PREGNA
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‣ What are the first signs of pre
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• Comfortable clothing and footwe
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o Abdominal pain o Weakness, tiredn
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Discuss with participants how they
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Flipchart FACTS ABOUT WOMEN’S LIV
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Trainer document NORMAL BODY CHANGE
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Trainer document/Participant docume
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Trainer document MYTHS AND FACTS RE
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Work and domestic activities Pregna
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Trainer document CASE STUDIES Elena
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II-IV. POSTPARTUM VISITS (45 minute
Page 133 and 134: Suggest that another important topi
Page 135 and 136: Trainer document WOMEN’S NEEDS DU
Page 137 and 138: Participant document COUNSELING ON
Page 139 and 140: Explain why newborns need a lot of
Page 141 and 142: • Beside routine weekly visits of
Page 143 and 144: Trainer document ESSENTIAL NEWBORN
Page 145 and 146: Trainer document/Participant docume
Page 147 and 148: SESSION 9: BREASTFEEDING OBJECTIVES
Page 149 and 150: • Every child should be exclusive
Page 151 and 152: 1. Demonstrate how to help a mother
Page 153 and 154: - for sick or disabled babies. 3. D
Page 155 and 156: Some women have very large areolas,
Page 157 and 158: • The baby suckles as often and f
Page 159 and 160: Flip chart BENEFITS OF BREASTFEEDIN
Page 161 and 162: Participant document PRINCIPLES OF
Page 163 and 164: Overhead BABY’S ATTACHMENT TO THE
Page 165 and 166: Participant document Sore or Cracke
Page 167 and 168: Trainer document ANSWERS TO FREQUEN
Page 169 and 170: Trainer document MYTHS ABOUT BREAST
Page 171 and 172: SESSION 10: SEXUALLY TRANSMITTED IN
Page 173 and 174: • The sexual act can be vaginal,
Page 175 and 176: sick and spread to others. ‣ How
Page 177 and 178: cells (which fight against infectio
Page 179 and 180: Participant document WAYS TO SIGNIF
Page 181 and 182: Trainer document HIV/AIDS: WHAT IS
Page 183: Participant document HOW IS HIV/AID
Page 187 and 188: Trainer document CAUSES OF INFERTIL
Page 189 and 190: SESSION 12: BREAST AND CERVICAL CAN
Page 191 and 192: • For health problems like cancer
Page 193 and 194: Participant document BREAST SELF-EX
Page 195 and 196: SESSION 13: BASIC CONCEPTS OF COMMU
Page 197 and 198: ‣ What is the purpose of talking
Page 199 and 200: ‣ How do you feel about asking wo
Page 201 and 202: • I was told to come • I learne
Page 203 and 204: Distribute the participant document
Page 205 and 206: Trainer document FACTORS INFLUENCIN
Page 207 and 208: • One's personal susceptibility t
Page 209 and 210: Participant document 7 stages BEHAV
Page 211 and 212: Participant document DECISION-MAKIN
Page 213 and 214: SESSION 14: INTERPERSONAL COMMUNICA
Page 215 and 216: o Note next to each of their respon
Page 217 and 218: IV-VII. ACTIVE LISTENING (20 minute
Page 219 and 220: ‣ What did she communicate to the
Page 221 and 222: ‣ Did you want to put conditions
Page 223 and 224: Open questions help women: • To a
Page 225 and 226: The person who was listening: • P
Page 227 and 228: Divide the group into 5 small group
Page 229 and 230: Refer the group to the flip chart F
Page 231 and 232: Ask participants to change roles wi
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"You're acting like a child." "You
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Participant document ACTIVE LISTENI
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Participant document EXAMPLES OF QU
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Flip chart / Participant document R
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SESSION 15: GROUP EDUCATION SESSION
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• How long people have held these
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o Involve simulations, role play an
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‣ How many people see: a young l
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o Introduce the subject o Invite th
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‣ What did the mediator do to put
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Participant document CONTINUUM IN T
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Flip chart CONTINUUM IN THE EFFECTI
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Common teaching/animation methods:
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Trainer document DESCRIPTION OF ANT
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255 RFHI/JSI Romania Training of RH
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Participant document FACILITATING G
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Participant document CHECKLIST FOR
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Possible questions for facilitating
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Note: It is important that all part
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SESSION 18: EVALUATION OF THE TRAIN
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Participant document HEALTH MEDIATO
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Matching questions Below are two li
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II. Other aspects of the training B
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Training of Roma Health Mediators in Reproductive Health

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