Tatiana Popovitskaya, Reproductive Health Alliance, Kyrgyzstan
Co-author: Galina Chirkina
For a long time abortion has been used as the main method of contraception in Kyrgyzstan. According to independent research, 7 out of 10 pregnancies end in an abortion. Young people under the age of 19 account for more than 200 abortions each year. This takes into account only the officially recorded and reported abortion figures. 70% of all abortions are still performed using dilation and curettage (D&C) contributing to the high level of post-abortion complications. The systematic underreporting of abortion figures is another sore point. Research performed by the Reproductive Health Alliance Kyrgyzstan (RHAK) showed that only one in 8 abortions performed in governmental clinics is registered and private clinics do not report their abortion figures.
According to the official figures of National Statistic Committee of Kyrgyz Republic the number of abortions has increased, especially amongst young people between 13 and 19 years of age*. At the same time we can see that the rate of contraceptive use by adolescents also decreased during the last 5 years by 1.8 times.
Several barriers to reproductive services influence the choices for adolescents in Kyrgyzstan:
- Adolescents have limited access to quality information and there is no sexuality education
- Adolescents have limited access to information on contraceptives and to contraceptives
- Adolescents are victims of violence based on tradition and violence within families and communities**
- Lack of quality of abortion care in the country; in 70% of the cases abortions are performed by D&C
- Lack of governmental commitment towards adolescents’ reproductive health
RHAK has played an important role in recognizing the need of young people to be able to access quality reproductive health services and has implemented several strategies to improve the reproductive health of young people in Kyrgyzstan. RHAK is now operating their own clinics providing high quality abortion services.
The Safe Abortion and Family Planning clinics in Bishkek (capital city) and Karakol were established under a Safe Abortion Action Fund project and further supported by IPPF EN through the GCACI project and SALIN+ project. The main goal of the clinics is to increase access to high quality information and services on abortion and family planning for young girls and women, especially poor, marginalized, socially excluded and underserved groups. The doctors were trained in safe abortion methods using Manual Vacuum Aspiration (MVA) and trained on providing pre - and post abortion counselling and contraceptive services. Clients can receive contraceptive services in the clinic and young people receive all services free of charge.
RHAK is recognised as the leading expert on safe abortion in the country and has delivered government sponsored training to a total of eight governmental clinics of family medicine and three maternity hospitals.
Besides medical services the RHAK clinics are also involved in prevention activities like information campaigns aimed at young people, open – door days, group consultations or discussions with students and schoolchildren which the aim to further reduce barriers to accessing services provided by RHAK clinics.
RHAK believes and proves that an NGO can be a good promoter of safe abortion and can successfully train service providers, assess the quality of care, increase the knowledge of the population as well as the medical and business community, support and develop safe abortion pilot clinics and projects, join forces
with key partners for advocacy and promotion of safe abortion.
*The official rate of abortions in the age group from 13 to 19 in 2009 was 3,6 for 1000 girls, in comparison with 2008 –3,0 and 2005 - 2,9 for 1000 girls.
**An example of such a violent tradition is bride napping or bride kidnapping also known as as marriage by abduction or marriage by capture.