System development in sexual and reproductive health and rights (SRHR) – Central Asia
Title: System development in sexual and reproductive health and rights (SRHR) – Central Asia
Commissioned by: German Federal Ministry for Economic Cooperation and Development (BMZ)
Country: Kyrgyzstan, Tajikistan, Uzbekistan
Lead executing agency: Ministries of health, social development, education and young people
Overall term: 2009 to 2018
In Central Asia, services to promote sexual and reproductive health and rights (SRHR) and prevent HIV and addiction are still unsatisfactory. Infant and maternal mortality rates are high. Central Asia is one of the regions where the HIV infection rate is increasing most rapidly. Those affected are primarily from poorer social groups, women and young people, as well as marginalised groups. People in rural areas in particular only have limited access to services in the areas of SRHR and HIV and addiction prevention. On the one hand, government and civil society institutions lack the capacities required to offer high-quality health care and services that are tailored towards different genders and target groups. On the other, as a result of social taboos among other things, a lack of knowledge about SRHR and HIV transmission prevents the take-up of services and increases health risks for the population.
It is easier to access gender-sensitive, human rights-based, integrated services for sexual and reproductive health and rights, and for HIV and addiction prevention.
The partner countries are being supported in the following main areas of activity:
- Improvements in the quality of SRHR services. The promotion of practice-oriented basic and further training for health professionals, institutional capacity building and the development, adaptation and implementation of standards for health facilities improve the quality of services in the long term. Target-group-oriented information increases the take-up of health and advisory services, which in turn brings about changes in behaviour.
- Health promotion among young people. Organisations that work with young people and vulnerable groups are supported in developing and implementing interactive, participatory methods to promote SRHR and prevent HIV and addiction that are suitable for young people. The role of the health ministry in coordinating multisectoral cooperation among governmental and non-governmental institutions is strengthened.
- Improvements in the conditions for accessing SRHR services through basic social protection. The ministries for social development in Kyrgyzstan and Tajikistan are being advised how to introduce and improve basic social protection programmes so that they can enable or facilitate access for poor people, especially women, to SRHR and to HIV and addiction prevention services.
Regional networks, exchanges of experience and joint learning processes between the partner countries, as well as transnational initiatives and the establishment of networks are important components of the regional programme in all its key activity areas.
Results achieved so far
The programme strengthens many partner institutions in Tajikistan, Kyrgyzstan and Uzbekistan through a variety of measures and as a result contributes to improvements in the quality of the services offered in the area of sexual and reproductive health. This has been done, for instance, by providing further training to medical professionals and hospital management, by updating accreditation standards for maternity hospitals and developing a monitoring and mentoring system for quality assurance. Target-group-oriented SRHR education strategies have been developed and tested successfully in all three countries.
- In all three countries, more than 50 maternity clinics have implemented the WHO’s Safe Motherhood Initiative and measures to improve quality.
- In 1,300 mahallas (neighbourhood organisations) in Uzbekistan, key actors who play an important role in family planning, such as mothers-in-law and religious leaders, have been given further training in reproductive health and health education. This is a decisive step towards strengthening self-determined family planning by men and women.
- National resource centres have been established in Kyrgyzstan and Tajikistan, in order to educate young people about health. Both are fully operational, serve as documentation centres and offer training courses for interested youth organisations, for whom these centres act as a bridge to government structures. In all three countries, the programme supports more than 30 non-governmental organisations and government partners that work with young people and vulnerable groups. Needs-oriented advice on organisational development and specialist training courses strengthen the organisations’ expertise and performance capacities.