Situational analysis Slovak Republic

1
Situational analysis Slovak Republic

• FIGO working group on unsafe abortion, Chisinau,
  Moldova
• 28. 9. 1. 10. 2008

2
Abortions in Slovakia legal framework

• Abortions in Slovakia are legal from 1957
  (in that time as a part of
  former Czechoslovakia)
• Condition for women interview in abortion
  committee
• Amendment of abortion law 1986 deletion of
  abortion committees
• Abortions in Slovakia are registered and
  published due to official publications of
  National Health Information Centre from 1960.
• Template Request for induced interruption of
  pregnancy and abortion report
• In Slovakia does not exist problem of unsafe
  abortion yet

3
Incidence of unwanted pregnancies

• End of the 80-ies in 20th century Slovakia (as
  part of former Czechoslovakia) was at the top
  among countries with the highest number of
  abortions in the world
• In 1989 48603 abortions on request
  43/1000 women in fertile age (NCZI).
• In 2006 11 971 abortions on request
  lt10/1000 women in fertile age (NCZI).

4
Reasons for high number of abortions

• Liberalization of abortion law in 50 ies was in
  environment without sex education and without
  contraception
• Introduction of contraception in 60-ies was in
  environment with negative attitude not only from
  lay public but professionals as well
• Sterilization was almost out of reach
  (legislative barrier)
• Abortions was free of charge
• Abortions were used to regulate fertility instead
  of contraception.

5
Changes in social environment after political
transformation in 1989

• Pro life versus pro choice activities
• Foudation of Slovak FPA (1991) in IPPF network
• Support for family planning philosophy,
  protection basic reproductive human rights,
  support for sexuality education, contraception
  and quality of reproductive health services.
• Activities for maintenance of access to safe
  abortion services for women.

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Tab.1. Abortions by type and age of women
Statistical Yearbook of the Slovak Republic 2006
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Graph. 1. Development of natality and artificial
abortions (NCZI- national center for health
information)
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Graph. 2. Relationship between deliveries and
artificial abortion (NCZI)
9
Graph. 3. Relationship between artificial
abortions and contraception (NCZI)
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Graph4. Hormonal contraception in Slovakia
(Source IMS)
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Tab.3. Vulnerable groups asylum seekers
Women without permanent residence in Slovakia do
not have access to legal abortion services
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Vulnerable groups Roma community

• Quantitave aspects of the problem
• 8-10 of population participates in some regions
  by 40 and more on natality
• Qualitative aspects of the problem
• low education level, disability to succeed on
  work market
• Regions with almost 100 of Roma unemployment,
  high morbidity and low life expectancy

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Graph.5. Two models of demographic behaviour
tree of life zdroj Populacní vývoj CR - 1995

• whole population
• Roma

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Vulnerable groups Roma community

• Roma community is not homogenous. Problematic is
  the part of Roma community living segregated, in
  settlements often without any basic
  infrastructure, legal relationships referring to
  the rights of property, inadequate hygienic and
  social conditions, and low educational and
  cultural level.
• Unequal position of Roma women in family
  hierarchy, multiparity, lack of information about
  possibility how to control own fertility and lack
  of support from community.
• There are still existing economical barriers
  towards family planning methods.

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Tab.4. Unemployment rate in Slovakia (Comparison
with selected EU countries)
(Statistical Yearbook of the Slovak Republic 2006)
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Tab.5. Infant death under 1 year of age/1000 life
birth in Slovakia (Comparison with selected EU
countries)
(Statistical Yearbook of the Slovak Republic 2006)
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Vulnerable groups Young people
Tab. 6. Contraception usage at the first sexual
intercourse by age (in )
Focus 1997
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Tab.2. Changes in prevalence of artificial
abortions according to age (NCZI)
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Research on sexuality Public opion pool FOCUS
1997

• 92 of women aged below 45 years had previous
  sexual experience at the time of their marriage.
• 70 of fertile-age women think that the optimum
  number of children is two.
• The view that under all circumstances a woman
  should have the right to decide on her pregnancy
  including abortion highly prevails in Slovakia.
• The most serious obstacle to the use of
  contraception is the fear of health side-effects,
  followed by religious reasons.
• Slovakia do not have systematic collection of
  specific data regarding sexual behaviour.

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Sexuality education

• Lack of official curricula for sex. education
• Lack of preparation teachers for sex. education
• Double track education religious versus ethical
  education conflicts of two points of view
  (civic versus religious)
• Lack of minimum sex education standard
• Result of situation increasing number of
  unwanted pregnancies et STIs in age group 15-25.

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Pro life activities

• Good coordinated on the level of official
  Catholic Church, Parliament, and Catholic NGOs.
• Long-time tendency to put abortion out of law
  criminalization of women, physicians and pro
  choice activists.
• So called polish strategy mass medial
  activities, emotional words physicians are
  murderers of unborn children, attacks against
  ethical code of medical chamber, effort to get
  existing law against Slovak Constitution, attacks
  against sex.education and contraception
  (human life is
  worth to be protected)

22
Vatican agreement and abuse of conscientious
objection

• Vatican agreement uncertainty defined
  obligation of Slovakia to respect Catholic
  attitude towards sexuality, origin of life trap
  in future development.
• Conscientious objection right of individual
  persons not right of health facility.
• Abuse of this right by heads of health facilitis
  and expansion of this right to whole facility.
• Reduction of access to reproductive health
  services including abortion services.
• Lack of state policy to secure quality of
  reproductive health services and accessibility
• risk of development towards unsafe
  abortions.