Commentary on women-centered reproductive health services.

From women's perspectives, the primary principles of a reproductive health framework in the developing world are as follows: Family planning is a basic human right to which all human beings are entitled. Provision of family planning services must be comprehensive, including safe and low cost methods, freedom of choice about both contraception and pregnancy termination, timely and honest information, privacy and confidentiality, individual needs assessment, and counseling of women, men or the couple. Wide contraceptive choice requires more research on methods that are less invasive of women's anatomy and physiology and more supportive of women's control of their own bodies. These parameters of quality care in family planning must be centered on women's needs, desires and expectations. The concept of conscious contraception implies an attitude of conscious sexuality. When a woman accepts that sexual gratification independent of reproduction is a legitimate right, she is better prepared to engage in the pursuit of her own health and happiness. If family planning programs do not include sexuality as a key issue to discuss with clients, all long-term strategies will fall short in modifying people's attitudes, especially women's reluctance to contracept. Sexual and reproductive health includes emotional health. As Dr. Sai points out, the effects of underdevelopment and poverty strike women in dramatic ways, and quite often all the pressures to which they are exposed lead to precarious emotional health. They become victims of violence and repeat the cycle of violence with their children. We, as advocates of sexual and reproductive rights, must also consider the psychological and emotional implications of sexuality and reproduction, and learn to deal with them in our clinics and services.(ABSTRACT TRUNCATED AT 250 WORDS)