Reproductive Health Advocacy

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Reproductive Health Advocacy

• Zane Krastina,
• Latvias Association for Family Planning and
  Sexual Health

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Reproductive health indicators ( WHO
Reproductive health indicators for global
monitoring 1996,1997)

• Fertility rate
• Contraception use
• Maternal mortality
• Perinatal mortality
• Abortion rate
• STI rate
• ..

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Maternal mortality
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(No Transcript)
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Contraception use in Latvia(per 1000 women age
15-44 )Health statistics department, 2002
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COC in Europe (UN Population Division, 2001) ()
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STI in Latvia (per 100 000 ) 2001
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(No Transcript)
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Abortions in Latvia (total numbers)
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Abortions per 1000 live born(PVO,HFA, 2002)
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World Wide advocacy for Reproductive Health

• 1994.
• ICPD International Conference for Population
  and Development
• UN
• POA Program of Action

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Continued by

• 1999.
• ICPD 5 Conference in Hague
• V.Makarovs, Minister of Welfare

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POBLEMS

• Governments and officials change, newcomers do
  not continue what was started earlier
• Political/global recognition does not guarantee
  practical/local support
• Some administrators hold new initiatives and
  ideas - why?

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• Is Reproductive Health a subject of public and
  governments interest?

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RH Law

• 1996
• Silence
• Feb, 2002 - adopted, since July 1, 2002 - in
  action

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Surprises

• Abortion as the main subject in RH public
  discussion
• Many anti choice groups, mainly religious,
  advocate to prohibit abortion

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Surprises

• Many public discussions (interviews, interactive
  voting in live TV progr., internet discussions
  etc.) dominate anti-choice mood
• Very few organisations and officials express
  their pro-choice believes openly, they try to
  avoid this question

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Mass media discussion(from study carried out by
Latvia University)

• Main themes
• - Church wants abortion to be illegal
• Abortion is cruel murder
• Reasons of abortions
• Doctors experience (I am doing abortions, I
  made her change decision)
• Womens experience (dominated by description of
  feelings after abortion)

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Mass media discussion

• Discussion leaders/main advocates
• - Church representatives (mostly men)
• Politicians, official bodies (mostly men)
• Doctors (mostly women)
• NGO
• common people with their attitude and
  experience (mostly women, except internet sites)

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Mass media discussion

• Doctors discussion
• Duty
• Medical consequences
• Tolerant, understanding attitude
• Stories from practice

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Mass media discussion

• Society groups which are connected with the
  issue, but not involved in discussion
• Man (participated in creation of this child)
• Man (could take part in decision making process)
• Man (could be a father
• Only one good public discussion of 3 popular
  musicians in young girls magazine

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Mass media discussion

• Statistical data and comments
• Political parties support church in way that
  abortion can not be provided for womens free
  will
• Thoughts of politicians and officials

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G. Bakulis, Latvias Lutheran, February 2, 2002

• we have to understand who needs this law to
  prohibit abortion, against whom it will be
  pointed and who will be protected by that.
  Christian church definitely does not need this
  prohibition. Non-believing state and society,
  outside the church needs it. And that way those
  good intentions to make society adopt its laws
  according to the Gods will is wrong.

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G. Bakulis, Latvias Lutheran, February 2, 2002

• Luther's teaching means that society should be
  ruled by common and rational sense, to promote
  development, stability and wellbeing. And Holy
  Spirit rules the church. We can not rule the non
  believers society by Gods rules.

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ADVOCASY PROVIDERS

• Professionals
• NGOs - FPAPapardes Zieds, Red Cross, Youth
  against AIDS
• State organisations - VVC, Centre for AIDS
  prophylactics, State family centre

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Family Planning Association as advocate for RH

• Since 1994
• Recent campaigns/projects with advocacy elements
• Prophylactics, diagnostics and treatment of
  reproductive tract infections evaluation of
  certain activities effectiveness in two towns in
  Latvia (WHO)
• Youth friendly services (UNDP)
• For womans health and free choice(SOROS)
• Emergency contraception in Latvia(GR)
• Oral contraception(few pharmaceutical comp.)

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EMERGENCY CONTRACEPTION

• WHY?
• EC became a real prescription medication since
  June 2001
• unsatisfied patients and physicians
• since April 2003 - non prescription, another
  product in the market

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Prophylactics, diagnostics and treatment of
reproductive tract infections evaluation of
certain activities effectiveness in two towns in
Latvia (WHO)

• To evaluate the most effective ways to improve
  health care quality and society knowledge about
  RH, especially STI,
• April 2002 - Dec 2003
• Ludza and Kuldiga

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YOUTH FRIENDLY SERVICES

• Necessity for better quality health information
  and specialist access for young people
• high rate of STI among young (highest 20 - 24
  years)
• insufficient confidentiality and attitude in
  former policlinics
• high prices in private offices
• no special youth clinic

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Oral contraceptives

• Low percentage of COC use in comaprison with West
  Europe
• One of the main reasons for non using - afraid
  of side effects (from social study done
  prelimenary the project, SKDS, n 300)

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For womans health and free choice (abortion
advocacy)

• Difficult issue to talk about
• Continuous discussion on the subject following
  adoption of the law
• Lack of common attitudes among professionals
• Difficulties to provide full choice of different
  options (Ru484) as regulatory authorities

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CONCLUSION

• Democratic, informed, educated society up to
  date professionals should and can advocate
  rational regulations to provide sustainable
  environment in reproductive health everybody
  has to add his/her had to move the large stone