Priorities for reproductive health: assessing need in the older population in the Asia-Pacific region.

Best practice in healthcare entails the identification of priority health needs so that scarce resources can be most appropriately deployed in the development of services. In this light, the priorities for health of older women and men in the Asia-Pacific region are considered in terms of reproductive health. A broader definition of "reproductive health" is used here, which considers conditions that affect the reproductive systems of older women and men. Although previous fertility history may influence some of these conditions, such as breast or cervical cancer or uterine prolapse, others -- including sexually transmitted diseases and impotence -- emerge as independent factors; that is, they relate directly to past and/or current sexual activity. Regional and country-specific survey data and the estimates of deaths and disease burden provided by the Global Burden of Disease Inquiry Project show that a component of the overall health problems of older women relate directly to pregnancy and the practice of unsafe sex. The lack of data for other conditions that affect the reproductive systems of older women and 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.