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Uzbekistan birth control program criticised
– Reported, May 24, 2013
Contraceptives are supposed to be provided free in Uzbekistan, according to Health Minister Adkham Ikramov. The IUD is the most popular contraceptive, used by 61.9% of women of childbearing age. Hormone contraceptives (pills or injections) are used by 34% of the women but are not available for free, contrary to the ministers assurances.
Most women choose the IUD because of its availability. But IUDs are not suitable for every woman, doctors say.
IUD insertion needs to be preceded by tests, pelvic untrasound, and a comprehensive medical examination to rule out any pathology, gynaecologist Lola Kakharova said.
But some of her colleagues said they seldom prescribe those tests amid unofficial instructions to persuade women of childbearing age with two or more children to have an IUD implanted.
Uzbekistans population is about 27m, or 44% of the Central Asian population, according to the Tashkent-based Institute of Prognostics and Economic Research. The number of annual live births has fallen from 723,000 in 1991 to 508,000 in 2009.
The reason for the crackdown today is that the record number of children born in 1991 are now of childbearing age.
The government needs to reduce the birth rate; thats why it spends huge sums on contraceptives for women, the political scientist said.
With that in mind, the Health Ministry in March issued decree No. 40, On Voluntary Surgical Sterilisation (VSS).
VSS is performed on women for whom pregnancy is contra-indicated or who cannot use other methods of contraception, Perinatal Centre Director Adelina Lyubchich explained. A qualified doctor is supposed to do the procedure free of charge and with the couples consent.
Each woman and her husband must have full information about VSS with a view to improving the womans quality of life, a Health Ministry press release says.
Lack of education contributes to the problems women face with IUDs.
Several times a month, we take educational trips to various parts of the country to consult with women on different methods of contraception and other health issues, said Nigora Ruziyeva, a physician at the republics Perinatal Centre and member of a mobile group implementing a 2009-2013 government program to improve womens health awareness.
But, according to her colleague, Niso K., each team member has a quota of IUDs to implant during each trip. This is a gross violation of the medical procedure that may have disastrous, irreversible consequences, she said.
Shavkat Mirodilov, a physician at Uzbekistans Obstetrics and Gynaecology Institute, called most educational campaigns purely formal. People know little even about elementary hygiene, and less so about contraception, which is totally taboo in many families, he said.
Linara Aripova illustrates the disconnect in communication.
Right after childbirth, I had visitors from the clinic who asked me to sign a paper saying they had consulted me on the methods of contraception and that Id had an IUD implanted although I actually take contraceptive pills, Aripova said.
And Gaparova will have to take expensive hormone pills for the rest of her life because she wasnt a good candidate for an IUD. Ive been advised to sue, but that wont return my former good health to me, she said.
CREDITS.
http://centralasiaonline.com/
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