The Diploma in Sexual and Reproductive Health (DSRH) in Developing Countries is a challenging course. There is a need of health personnel all over the developing countries. It is a specialised course for people working in the health sector.
The DSRH course offers an opportunity to examine and discuss issues surrounding sexual and reproductive health in a low resource setting context. The course focuses on those aspects of reproductive health that are within the scope of health professionals to address, either through influencing policy, better management of health services, research, or, training others to provide effective services that are of good quality and are women-friendly.
During the course, emphasis will be focused on participation, interaction and discussion. Interaction with colleagues from across the globe, discussion with experts in the areas identified and possibility to address issues in detail will enable each candidate to explore ways of improving their professional work.
The causes of ill health and morbidity are multifactorial and are strongly influenced by the socio-economic environment in which people live. Poverty is a major barrier for individuals and communities seeking to improve their own health. It is important for health professionals to consider issues of access and equity in their efforts to provide effective care. SDG 3 has one of its targets focusing on Universal Health Coverage(UHC) which aims at addressing the financial barrier to accessing health.
For this course, a specific but fairly broad definition has been selected for reproductive health which focuses on women, because of their central role of childbearing. However, any change needs to involve men and programs should target them too.
Until recently services for women have generally focused on fertility regulation in the form of family planning programs for women aged between 15 and 45 years and on obstetric care including emergency obstetric care and skilled attendance at birth. The focus has also often been on women as mothers and may have neglected other health needs that women experience.
The definition of reproductive health adopted at the International Conference on Population and Development in 1994 captures the essential characteristics that make reproductive and sexual health unique compared to other fields of health. Reproductive health extends before and beyond the years of reproduction, and is closely associated with sociocultural factors, gender roles and the respect and protection of human rights, especially – but not only – in regard to sexuality and personal relationships.
“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 choices, 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, reproductive health care is defined as the constellation of methods, techniques and services that contribute to reproductive health and wellbeing 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.
Bearing in mind the above definition, reproductive rights embrace certain human rights that are already recognized in national laws, international human rights documents and other consensus documents. 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. (Programme of Action of the International Conference on Population and Development, New York, United Nations, 1994)
The DSRH course focuses on more specific aspects of women’s health than those covered in the above definition, but acknowledges that the broader issues surrounding women’s health cannot be ignored or forgotten.
The WHO Safe Motherhood Newsletter (1994) used the following definition of reproductive health:
“Reproductive Health implies that people have the ability to reproduce, to regulate their fertility, and to practice and enjoy a wholesome sexual relationship. It implies women can go safely through pregnancy and childbirth, that fertility regulation can be achieved without health hazards and that people are safe having sex. Finally, it implies that reproduction is carried to a successful outcome through infant survival and lays the foundation for future health and development”.
This definition of reproductive health addresses sexual behavior, family planning, maternal care and safe motherhood, abortion, reproductive tract infections including sexually transmitted diseases and HIV and AIDS and sexual and gender-based violence. It is this definition that reflects most accurately the scope of the present DSRH course.
Course Aim, Learning Outcomes and Structure
The programme is aimed at those who work, or are planning to work, in areas of sexual and reproductive health (SRH) in low resource settings. Examples include Ministry of Health programme officers, individuals working in health non-governmental organizations, district health officers, medical doctors and nurse midwives involved in clinical care of patients, pre-service medical and nurse-midwife tutors and sexual/reproductive health advocates to name but a few. The course is designed to provide students with the in-depth knowledge of SRH and skills on designing, implementing and evaluating healthcare programmes which will enable them to contribute to local healthcare development focused upon population needs. Students study full time in Liverpool which includes studying alongside students on the Masters in International Public Health – Sexual and Reproductive Health pathway for some of their sessions.
Course learning outcomes
The DSRH is designed to help doctors, midwives and other health professionals acquire knowledge, understanding and skills that will enable them to:
- Develop a systematic understanding of the social determinants of sexual and reproductive health in a wider public health context.
- Develop a systematic understanding of the national and international health policy which may affect provision of sexual and reproductive healthcare.
- Critically evaluate evidence on sexual and reproductive health issues in low resource areas.
- Communicate knowledge effectively both verbally and in writing.
- Manage projects and meet deadlines by setting priorities and goals
- Be confident in basic IT skills needed in literature search, academic writing and presentation
- Appreciate differences and demonstrate sensitivity and understanding when working with others from different backgrounds and cultures.
- Take responsibility for own learning and become a lifelong learner in the area of sexual and reproductive health.
Throughout the course the emphasis will be for the participants to gain sufficient confidence in new skills and ideas to be able to begin to develop them in their working environment and with colleagues in a developing country situation. The course will put an emphasis on discussion groups and participation with a minimum of didactic lecturing. It is therefore important for students to be actively involved to benefit fully from the course.
Learning Methods: Classical Learning(Face-to-Face); Online Learning, and Self -Study
The course is organized into 8 Units as follows:
Unit (Week) Area of study
- Unit 1 (Week 1): Introduction to the course, key skills needed for the course including research methods and use of information technology.
- Unit 2 (Week 2): Introduction to Sexual and Reproductive Health and Biostatistics and Epidemiology.
- Unit 3 (Week 3 -5): Planning and Provision for Maternal and Newborn Health Services -including emergency obstetric and newborn care.
- Unit 4 (Week 6): Health Systems, Policy and Governance in Sexual and Reproductive Health.
- Unit 5 (Week 7) Caring for the sexual and reproductive health needs of adolescents.
- Unit 6 (Week 8 – 9): The Importance of Sexual Health and Human Sexuality in Sexual and Reproductive Health Care
- Unit 7 (Week 10 – 13): Self-directed study and assessments
- Unit 8 (Week 11 -12): Quality improvement in Sexual and Reproductive Health and Qualitative research methods.
The first week of the course will be spent on introductions and settling in followed by lectures on the basics of qualitative research including some of the key lectures including Epidemiology and Statistics in week 2. Week 3 to 4 target public health aspects of maternal and new-born Health, followed by a practical skills training course in week 5. Week 6 covers main concepts of SRH with lectures on health systems and introduction into health management and planning. Week 7 is specific on adolescent health issues. Week 8 and 9 will focus on different aspects of sexual health and human sexuality. In week 10 you will have the opportunity to present your assignment findings. In week 11 and 12 quality improvement methods in maternal and new-born health.
During the course students are given the opportunity to conduct a literature review on a topic of their special interest which forms part of the formative assessment. The assignment is submitted and feedback is provided to help them in writing the dissertation. The assignment focusses on needs assessment of a particular Sexual and reproductive health problem in a chosen setting. This work forms the dissertation which is submitted at the end of week 10. Based on this dissertation a student is supposed to prepare a 10 minute presentation of key points from their work which is assessed in week 10 as well.
Students will be introduced to Global Academy and opening sessions will be used to set the overall scene and background to the course. There will be an introductory session to familiarize the participants with the Academy and how to conduct a computer-based literature search.
The course will introduce different research methodologies as applicable to Reproductive Health. Sessions will cover both quantitative and qualitative research methods.
Qualitative research methods will be covered in week 12. The sessions cover principles of qualitative research, approaches and methods, different types of interviews, their advantages and disadvantages will be introduced including planning and implementation. Sessions will also cover analysis of qualitative data and ethical issues related to data collection.
Principles of Epidemiology and Statistics
During the introductory weeks of the course students will explore the relevance of epidemiology and statistics to reproductive health. Sessions will cover different epidemiological study designs as well as epidemiological and statistical concepts. Different measures of mortality and morbidity will be presented and explained how these can be calculated from routinely available data. The advantages and limitations of different sources of data and indicators available in developing countries will be discussed.
Critical Appraisal of scientific literature
The aim of this section is to encourage students to use and critically interpret published studies on reproductive health issues, and to appropriately apply the acquired knowledge for their literature review.
Key concepts in Maternal and Neonatal Health
This module will help students to understand the concepts of Maternal & Neonatal Health (MNH) and Safe Motherhood (SM), its historical development, the key strategies for reducing maternal and neonatal mortality and improving maternal and neonatal health, as well as the global strategy of WHO to improve MNH towards achieving SDG 3. Students will learn how to develop a strategic plan for the reduction of maternal and neonatal mortality, how to plan, organise and monitor & evaluate evidence-based MNH programmes, taking into consideration the importance of effectively functioning health systems.
Health Policy, Planning and Change-Management Concepts
Doctors and midwives are increasingly being called upon to manage health services and programs. To effectively meet these demands, it is vital that they have a good understanding of managerial principles and how these are applicable to the health services, particularly to reproductive health services. Students will be given an overview of management principles and its applicability to health care systems. They will learn how to plan, implement, monitor and evaluate sexual and reproductive health interventions.
Adolescent Sexual & Reproductive Health
There is a growing recognition that because of a combination of biological, psychological and social reasons, adolescents face many different health problems. Specific sessions will provide an overview of health issues and problems faced by adolescents and will challenge participants to examine their own perceptions, their clinical practice and existing health services. Students will be encouraged to consider how services can be improved to better meet the reproductive health needs of young people in their own countries.
Sexual Health and Human Sexuality
In this module the concepts of human sexuality, forms of sexual dysfunction and general principles of management as well as the principles of psycho-social sexuality counselling and comprehensive sexuality education will be introduced. Topics covered include the epidemiology of Sexually Transmitted Infections (STIs), including HIV, and methods for prevention and control as well as diagnosis and treatment of STIs. Lectures will also address sexual and gender-based violence (SGBV) and unsafe abortion. Students will also learn to recognise the role of FP in SRH, how to design FP programmes, how to monitor & evaluate specific FP interventions. Other module sessions will give an overview of FGM, obstetric fistula and cervical cancer.
Quality improvement in Maternal and New-born Health
This module aims to provide students with knowledge and critical understanding of the concepts of quality of care in maternal and new-born health. Students will learn the importance of improving quality of MNH care and services, how to assess quality, reflect critically on own area of practice and role in quality improvement and appreciate how research and audit differ and how they are related. In the specific sessions, quality improvement methods for MNH services, notably maternal death reviews, perinatal death reviews and standards-based audits will be introduced.
Assessment and Examination Regulations
The award of Diploma in Reproductive Health in developing countries is based on the results of the written assignment (dissertation), presentation and participation.
The marks are distributed as follows:
Assessment % of total Mark
Written Assignment 50%
The pass mark for all assessments is 50%. Students must attain 50% or above in all of their summative assessments.
Students will be awarded a PASS or FAIL. Students with a combined mark of at least 70% for all summative assessments will be awarded a DISTINCTION.
Course Starts: September 2021
Costs: Upon Request.
You can submit your application along with the copies of your qualification, work experience, English language certificate. Applications are open on a rolling basis.
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