Priorities for reproductive health: Assessing need in the older populationin the Asia-Pacific region

Best practice in healthcare entails the identification of priority health n eeds so that scarce resources can be most appropriately deployed in the dev elopment of services. In this light, the priorities for health of older wom en and men in the Asia-Pacific region are considered in terms of reproducti ve health. A broader definition of "reproductive health" is used here, whic h considers conditions that affect the reproductive systems of older women and men. Although previous fertility history may influence some of these co nditions, such as breast or cervical cancer or uterine prolapse, others -- including sexually transmitted diseases and impotence -- emerge as independ ent factors; that is, they relate directly to past and/or current sexual ac tivity. Regional and country-specific survey data and the estimates of deat hs and disease burden provided by the Global Burden of Disease Inquiry Proj ect show that a component of the overall health problems of older women rel ate directly to pregnancy and the practice of unsafe sex. The lack of data for other conditions that affect the reproductive systems of older women an d men is noted, as is the importance of further research if an individual's health needs are to be fully met. It is argued that healthcare and health services alone cannot meet some of the health needs of the older population ; broader political and social change are required.