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Providing Quality Reproductive
Health in Kyrgyzstan
Buried
deep in Central Asia, Kyrgystan is home to 5 million
people and the world's third highest mountain range.
However although 70% of the country is mountainous and
largely uninhabited, some of Kyrgystan's valleys are
among the most densely populated areas in the world. In
many remote, isolated villages, reproductive health
services are non-existent. Where services do exist,
the rugged terrain, inadequate roads, or lack of transport
have made it nearly impossible for people to reach them.
With 80% of the population living in poverty, basic
goods and services are hardly affordable. The
total fertility rate, unlike Russia, remains high, averaging
2.4 children per woman. Officially the infant mortality
rate is just 22 deaths per 1,000 live births, but WHO
estimates the real figure at closer to 50 deaths per
1,000 live births since people living in rural areas
do not report infant deaths earlier than 42 days after
delivery. Similarly,
the maternal morality rate appears to be increasing
slightly - from 42 deaths per 100,000 live births in
1999, to 45 deaths per 100,000 live births in 2000.
The main reasons cited for this are too many pregnancies
to adolescent girls, multiple births and short intervals
between births. To complicate the picture, over half
of all pregnant women suffer from alimentary anemia.
Many deliveries still take place at home without the
presence of a qualified birth attendant or doctor, increasing
the risk of both infant and maternal mortality. One
hopeful sign - some 40% of all women of reproductive
age are using some form of contraception. But this must
be maintained and enhanced if progress is to be made
in improving women's reproductive and sexual health.
The project has five main objectives:
- Increase
people's awareness of the recently adopted Law on
Reproductive Rights, which puts users into position
to have a stronger voice in demanding quality services
secured by the law.
- Identify
and document the impact of the health care reform
process on the provision and funding of sexual and
reproductive health services.
- Identify
ways and means of creating awareness among women of
their reproductive health and rights.
- Establish
pilot community-based initiatives aimed at improving
the quality of sexual and reproductive health care
by empowering clients and developing partnerships
with providers.
- Reallocating
core resources from UNFPA, ILO/STEP, UNICEF and WHO
during respective programme reviews and mobilizing
matching funds from other donors, including bilateral
development agencies.
The
following activities have been carried out during the
planning phase:
- Identification
of information and facilities necessary for project
development, including plan of action and timeline
for the planning phase.
- Synthesis
and dissemination of existing knowledge through case
studies and situational analyses and presentation
of results at stakeholder workshops.
- Design,
implementation, monitoring and evaluation of pilot
projects in selected regions.
- Development
of funding proposal for full implementation phase.
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