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UNFPA works to improve reproductive
health services at the primary level. In this perspective, the Fund's
priority is to ensure the accessibility and the quality of primary reproductive
health services, especially for poor and vulnerable persons.
Situation analysis - Women's health
at risk
Like any other transition country, Kyrgyzstan has undergone changes in
virtually all fields of life. These changes have affected the system of
health care as well. The system that used to exist in the Soviet Union
proved too complex and costly for the small newly independent country.
Funding of public health dropped from 4 percent of the Gross Domestic
Product in 1995 to 2.2 percent in 2005.
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The impact of this lack of resources is visible in
the deteriorating physical infrastructure of health centres, which
often lack basic equipment and supplies. All of these factors have
significantly reduced the accessibility and the quality of medical
care, especially for the poorest population.
Women are the primary victims of this deterioration. They carry
a disproportionate share of the disease burden in the population,
with low levels of reproductive health. Only 40 per cent of births
are free of complications. The frequency of unsupervised births
is increasing. Although home deliveries are safe if supervised and
attended by trained personnel, this is not always the case, particularly
in remote villages with poor transport facilities. Hence, the maternal
mortality rate in Kyrgyzstan is one of the highest in the region. |
In order to address these problems, the government launched in 1993 the
Manas National Health Reform, which is now in its third phase. This set
of reforms focuses on strengthening primary health care through establishment
of family group practices. However, the reforms are not sufficiently sustained
because of lack of financial resources.
Key indicators on Reproductive Health
Indicator
|
Kyrgyzstan
|
Uzbekistan
|
Romania
|
Maternal Mortality
Ratio
(number of women's death per 100'000 live births) |
110 |
24 |
49 |
Infant Mortality Rate
(per 1000 live births) |
53 |
57 |
17 |
Fertility Rate
(average number of children per woman of reproductive age) |
2.59 |
2.61 |
1.26 |
Contraceptive Prevalence
Rate
(proportion of women using modern methods of contraception) |
49 |
63 |
30 |
| Health
expenditures
(% of GDP) |
2.2% |
2.6% |
4.2% |
| Source:
UNFPA State of the World Population Report, 2005. |
On the ground, UNFPA is.
.building capacity, through:
- Trainings for healthcare providers (gynaecologists, obstetricians,
urologists, andrologists, primary level health service providers, community-based
health councils, family planning specialists, etc) on technical issues,
as well as behaviour change communication, counselling skills, etc.
- Study tours abroad for healthcare providers
- Elaboration of training materials and clinical protocols on reproductive
health
- Assistance to medical schools and training institutions for reviewing
curricula
. distributing information, through:
- Development and distribution of informational brochures on sexual
and reproductive health
- TV and radio campaigns for prevention of sexually transmitted diseases
- Work with religious leaders on family planning issues
. ensuring access to medical commodities,
through:
- Distribution of contraceptives
- Procurement of adequate medical instruments (gynaecological equipment,
emergency obstetric care, etc)
- Support for an electronic logistics system to assess the needs and
the delivery of medical commodities
. working at the national government
level, through:
- Participation in roundtables on the Manas National Health Reform
- Harmonization of medical standards and data
- Promotion of a mechanism to target the poor, such as social passports
- Strengthening the links between the Ministry of Health and the Ministry
of Social Protection
| Excerpt
from the ICPD Programme of Action 1994 |
| Reproductive
health 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 choice, 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. (Paragraph
7.2) |
In Focus: Partnering with Religious
Leaders
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UNFPA Kyrgyzstan initiated a dialogue with national
Muslim religious leaders. This dialogue was based on the revision
and adaptation of the book "Family Planning in the legacy of Islam"
by Abdel Rahim Omran, an authority on population and demographic
studies. Various seminars were organised at the local and national
level, where vigorous debates took place on the interpretation of
religious texts discussing family planning.
UNFPA also took this opportunity to sensitize religious leaders
to issues of reproductive health and prevention of sexually transmitted
infections. At their request, religious leaders were provided with
extensive medico-scientific trainings.
As the discussions will come to an end in November 2005, an adaptation
of the book on family planning is expected to be agreed on and will
constitute an important document for future dialogue and trainings
at the grassroots level.
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Approximate annual budget, from regular
resources: USD 350'000
If you want to know more about UNFPA action
in improving reproductive health globally, check our
global
website.
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