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POPULATION OUTLOOK
Kazakhstan and Countries
of Central Asia
European Population Forum
Socio-Economic Development
KAZAKHSTAN - Achievements
• Fastest Growing Economy among CAR
– GDP growth 9.5% in 2002, 10.2% in first half
2003
– Inflation decreased to 7-8%
– Budget deficit decreased (1.4% surplus in
2003)
– Increase in social sector programmes
Socio-Economic Development
(cont.)
KAZAKHSTAN - Issues
• Poverty and Social Stratification
– richest 10% receive 26% of national wealth
vs. poorest receive only 2%
– Rural poverty is almost twice as much as
urban (38% vs. 20.4%)
– Most vulnerable least protected (women and
youth, especially in rural areas)
Socio-Economic Development
(cont.)
KAZAKHSTAN - Issues
• Population decline - since 1991 population
reduced by 1.7 million due to:
– emigration
– reduced fertility
– increased mortality (particularly among men)
Turkmenistan is also concerned with
population decline
Uzbekistan - high fertility in rural areas
Socio-Economic Development
(cont.)
KAZAKHSTAN - Issues
• Decreasing health status of population
– Unhealthy behavior practices
– Lack of life skills and knowledge of healthy
lifestyles
– Poor attitudes to own health
– Poor ecology
National Population and
Development Policies
KAZAKHSTAN
• National development strategies 2030 and 2010
• Poverty reduction programme
• Demographic and migration programme
• Rural development programme
• National Plan on environment for sustainable
development
National Population and
Development Policies(cont.)
Kyrgyz Republic – population issues addressed
in various documents, but no
integrated policy or strategy
exists
Turkmenistan –
social protection of vulnerable,
environmental and internal
migration policies
Uzbekistan –
population issues integrated
into development policies and
reforms
Tajikistan –
PRSP, environmental policies,
internal migration policies
Gender Equality, Equity and
Women Empowerment
• Kazakhstan and republics of Central Asia are the
signatories of the ICPD PoA and Beijing Platform
of Actions
• Legislation and relevant institution established
Kazakhstan – National Commission on Family
and Women Affairs under the President of RK
Uzbekistan – Bureau on Gender and
Development
Similar establishments and/or enabling
legislation on gender exist in Kyrgyz Republic,
Tajikistan and Turkmenistan
Gender Equality, Equity and
Women Empowerment(cont.)
Gender Violence and Discrimination
Kazakhstan
• Gender differentials in key socio-economic
indicators
• Gender Stereotyping
• Lower carrier perspectives
• Reported domestic violence
Similar situation in other CA countries
Gender Equality, Equity and
Women Empowerment(cont.)
Gender Violence and Discrimination
Kazakhstan
• Units combating abuse against women formed
in 1999 in the Ministry of Internal Affairs
• Network of crisis centers established
• Planned adopting of the Law Concerning
Domestic Violence and the Law on Introducing
Additions to the Criminal Code of the Republic
of Kazakhstan Regarding the Issues of Illegal
Trafficking and Migration for Purposes of Sexual
or any other Exploitation
Reproductive Rights and
Reproductive Health
Kazakhstan
• MMR is highest among CA countries – 50.5 per
100,000 livebirths
• High rate of pregnancy and delivery
complications – 60%
• Causes of maternal deaths
– Insufficient management of obstetric emergencies
(hemorrhages, infections, eclampsia, etc)
– Abortions
– Poor health & nutritional status
– Poor quality of antenatal care
Reproductive Rights and
Reproductive Health (cont.)
Kazakhstan
• Contraceptive prevalence rate on rise –
50.7 (MoH, 2002)
• Unmet need for family planning – 8.7%
(DHS, 1999)
• Access and quality of reproductive health
services poor, particularly in rural areas
Abortion Trends in Kazakhstan
• During 10 years the absolute amount of abortions
in RK decreased by 2.3 times. All indicators
defining abortions have improved: 1 abortion
accounts for each 2 childbirths
• Number of abortions per 1000 females in
reproductive age decreased by 2.2 times
• Number of abortions per 100 births decreased
almost twice
• But discrepancies between official and
independent sources on abortion and its
complications limits analysis of abortion related
maternal deaths
Abortions in Kazakhstan
350000
300000
250000
Total
abortions
200000
150000
Year
100000
50000
0
1993 1994 1995 1996 1997
1
2
3
4
5
1998 1999
6
7
2000 2001 2002
8
9
10
Adolescents and Youth
Kazakhstan
• STIs on the rise
• Drug abuse: 40,000 officially registered; estimated
250,000
• Smoking: 10% of adolescents under 14 years, 20%
under 16 years, and 70% under 24 years.
• Alсohol: 6% of adolescents under 16 years, up to 80%
of under 24s
• Reproductive Health: only 20% adolescents under 17
are healthy. 7000 abortions among girls under 17 of
which secundigravidae - 53,8% (NHLS, 2003)
• 24 HIV positive among adolescents under 14
• 411 HIV positive among adolescents 15-19 years
HIV/AIDS in Kazakhstan
• Spread of HIV/AIDS in Kazakhstan at a fastest
pace among countries of Former Soviet Union
–
–
–
–
3788 HIV positive in September 2003
205 HIV positive pregnant women
80% IDUs among HIV positive
17% of men and 33% of women ages 15 to 19 are not
aware of HIV prevention measures
• Enacted the Concept Paper and National
Programme on Counteracting of HIV/AIDS
Epidemic in the Republic of Kazakhstan for
2001-2005.
Partnerships
Partnerships
• UNFPA and other UN organizations,
development agencies and donors
• Government
• Civil Society
Best Practices
Kazakhstan
• Focus on quality of care enabled developing and
introducing evidence-based clinical protocols on a variety
of reproductive health issues
• A continuing series of training for health professionals on
modern contraceptive technology, management of STIs
and RH counseling by national experts and NGOs
• Alliance of the Government with international community
and civil society organisations paved the way for
introducing population dimensions into development
strategies
• Community-based distribution of information and services
demonstrated its high value as a tool for social
mobilization
Best Practices
Kyrgyz Republic – establishment of a community-based
Social Patronage System enabled
minimizing cases of infant and
maternal mortality
Turkmenistan –
advocacy efforts led to introduction of
gender issues into sectoral plans
Uzbekistan –
running of a social communication
campaign covering a broad spectrum
of reproductive health issues
Tajikistan –
participatory approach involving
Government agencies, technical
expertise and civil society resulted in
adoption of Poverty Reduction
Strategy Paper
Emerging Issues
Kazakhstan
• Low understanding of reproductive rights among
decision-makers may jeopardize development agenda of
the country pursuing pro-natalist policy
• Lack of national expertise in demography and social
statistics exacerbated by data problems
• Growing danger of HIV/AIDS well recognised but very
little action in place. Actual level of the disease is likely 810 times exceeds official figures.
• Low capacity to detect STIs. Real dimensions unknown.
High incidence of STIs may have serious impact on
reproductive health of entire population.
Health Legislation in
Kazakhstan
• The Constitution of the Republic of
Kazakhstan as of 30.08.95 according to
which the citizens have right to health care
• Citizens have right to get free guaranteed
package of health care
Legislation in the Area of
Reproductive Health
The Law of the Republic of Kazakhstan on Healthcare of
the citizen of RK asof 19.05.97 according to which:
• a woman has right to decide herself the issue on
maternity
• with a view of healthcare a woman has right to use the
modern methods of contraception
• maternity in RK is preserved and encouraged
• maternity care is ensured by organizing of the wide
network of specialized medical organisations, benefit
payments on account of child’s birth, efficient
employment of pregnant women, ensuring maternity
leave with benefit payments to child-care.
Legislation on health protection
of children and pregnant women
The Law of the Republic of Kazakhstan on Health
Protection of the Citizens of RK dated 19.05.97
according to which:
• the Government protects the rights and interests of
children who are to be under medical examination and
constant and dispensary observation
• Adults must care about children’s health, their physical,
intellectual and moral development,
to bring up
children to the healthy life style
• Pregnant women must get registered in maternity
healthcare centers
• Parents should follow regulations promoting the birth of
healthy children
Legislation
(continued)
The Law of RK on Marriage and Family as of
17.12.1998
• A person under 18 years old is recognized as a child.
• Every child has right to live and be brought up in a
family, to know her/his parents.
• Parents should provide care to their children
Health legislation has been implemented through the
State Programme Health of the Nation. Priorities
identified in the programme include protection of
maternal health, family planning, and building of
health lifestyles
Priorities of Reproductive
Health in Kazakhstan
Improvement of reproductive health of
population, formulation and training of
skills for responsible attitude of people
towards their own health
Non-Governmental
Organizations (NGOs)
• At the present time in Kazakhstan exist
more than 150 women’s NGOs
• Republican movement “Women of
Kazakhstan”, Coalition of women’s
NGOs in operation.
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