CONTRACEPTIVE CONTRACEPTIVE SECURITY SECURITY Issues for Central Asian Republics Issues for Central Asian Republics USAID SOTA Course October, 2002 Washington DC Mary Skarie, USAID/CAR
Jan 06, 2018
CONTRACEPTIVE SECURITYCONTRACEPTIVE SECURITY Issues for Central Asian RepublicsIssues for Central Asian Republics
USAID SOTA Course October, 2002 Washington DC
Mary Skarie, USAID/CAR
U.S. Agency for International Development U.S. Agency for International Development Central Asia Regional MissionCentral Asia Regional Mission
Population *Life expectancy *Per capita income *Religion
Kazakhstan - 14,9 mln. 57.8 - male $1,421 47%Muslim
68.9 - female
Kyrgyzstan - 4,7 mln. 59.2 - male $322 75%Muslim
67.9 - female
Tajikistan - 6,5 mln. 61.0 - male $286 80%Muslim 67.4 - female
Turkmenistan - 4,6 mln. 57.4 - male $652 89%Muslim
64.7 - female
Uzbekistan - 25 mln. 60.2 - male $488 88%Muslim
67.5 - female
2.89
2.05
3.37 3.34
0
1
2
3
4
5To
tal F
ertil
ity R
ates
TU-2000 KZ-1999 KY-1997 UZ-1996
DEMOGRAPHIC DATA - RECENT DHSDEMOGRAPHIC DATA - RECENT DHS FERTILITY
61.866.1
59.555.6
0
20
40
60
80
Con
trac
eptiv
e pr
eval
ence
rate
TU-2000 KZ-1999 KY-1997 UZ-1996
DEMOGRAPHIC DATA - RECENT DHSDEMOGRAPHIC DATA - RECENT DHS CONTRACEPTIVE USE
Use of Contraception by Currently Married Use of Contraception by Currently Married Women in Turkmenistan (DHS/2000)Women in Turkmenistan (DHS/2000)
Pills1%
IUD39%
Other modern methods
5%
Lactational amenorrhea
8%
Traditional methods
9%
Don't use38%
10.18.7
11.6
13.7
0
3
6
9
12
15
18
Per
cent
cur
rent
ly m
arrie
d w
omen
with
an
unm
et d
eman
d fo
r fam
ily p
lann
ing
TU-2000 KZ-1999 KY-1997 UZ-1996
DEMOGRAPHIC DATA - RECENT DHSDEMOGRAPHIC DATA - RECENT DHS CONTRACEPTION: UNMET NEED
0.85
1.4
1.55
0.67
0
0.3
0.6
0.9
1.2
1.5
1.8
Tota
l abo
rtio
n ra
tes
TU-2000 KZ-1999 KY-1997 UZ-1996
DEMOGRAPHIC DATA - RECENT DHSDEMOGRAPHIC DATA - RECENT DHS ABORTION
Lifetime Abortion in KazakhstanLifetime Abortion in KazakhstanBackground % of women who had Among women who have had an Mean numberCharacteristic an induced abortion induced abortion, % who have had of abortions Specific numbers of abortions 1 2-3 4-5 6+ TotalAGE <20 1.6 84.2 15.8 0.0 0.0 100.0 1.220-24 15.5 54.6 41.8 3.5 0.0 100.0 1.625-34 43.2 46.5 39.9 9.9 3.6 100.0 2.135+ 62.7 29.3 44.1 16.3 10.3 100.0 3.0
No.of live births 0 4.9 60.3 37.8 1.9 0.0 100.0 1.51 44.7 43.9 40.4 10.9 4.8 100.0 2.42-3 61.4 31.8 43.9 14.7 9.6 100.0 2.94-5 47.9 37.2 41.1 16.9 4.9 100.0 2.56+ 32.3 41.6 41.2 10.8 6.4 100.0 2.3
Ethnicity Kazakh 27.1 44.9 42.8 8.9 3.4 100.0 2.1Russian 55.4 31.4 41.0 16.8 10.8 100.0 3.0Other 51.9 30.6 45.3 15.2 8.9 100.0 2.8
TOTAL 39.6 36.2 42.6 13.5 7.7 100.0 2.7
Reference: DHS/Kazakhstan, 1999
Contraceptive Supply in Uzbekistan (1993-2002Contraceptive Supply in Uzbekistan (1993-2002))
Contributions in US dollars
1993 1994 1995 1997 1998 2000 2001 2002 2003
UNFPA: 828,000 728,000 249,000 421,600 208,560 1,135,000 119,000
KfW: 2, 000,000
USAID: 200,000 105,000
Government: 3, 000,000
TOTAL: 828,000 728,000 3,200.000 249,000 421,600 208,560 1,240,000 121,002
0
2000000
4000000
6000000
8000000
10000000
12000000
14000000
16000000
18000000
Pieces/Cycles/Vials
1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003
Years
Contributions in quantities of contraceptives contributed versus national need
QuantitiesNeeded
QuantitiesSupplied
Main Donors of Contraceptives
UNFPAKfWUSAIDGovernment
UNFPA-40,7%Government-18,6%
USAID-1,7%
KfW-39%UNFPA: 1993 - 2002KfW: 2003USAID: 1995, 2001Government: 1995
Reproductive HealthReproductive HealthSalient Issues:Salient Issues:
• High reliance on abortion (legal)
• Very limited range of contraceptives; heavy reliance on IUDs
• Severe constraints on government spending and non-convertible currencies
• Tepid donor commitment
• Dysfunctional/failing systems, including logistics
USAID ResponseUSAID Response
• Limited contraceptive donations to pilot areas in Uzbekistan
• Launch of Social Marketing Program
• New regional program on MCH/RH
•Planned contraceptive donations in selected areas
USAID ResponseUSAID Response
Policy dialogue with MOHs - partially successful collaboration with other donors: • DfID condom donation to Kyrgyzstan• KfW donations in Uzbekistan• Uzbek tender to procure 10% of national need