POPULATION OUTLOOK Kazakhstan and Countries of Central Asia European Population Forum Socio-Economic Development KAZAKHSTAN - Achievements вЂў Fastest Growing Economy among CAR вЂ“ GDP growth 9.5% in 2002, 10.2% in first half 2003 вЂ“ Inflation decreased to 7-8% вЂ“ Budget deficit decreased (1.4% surplus in 2003) вЂ“ Increase in social sector programmes Socio-Economic Development (cont.) KAZAKHSTAN - Issues вЂў Poverty and Social Stratification вЂ“ richest 10% receive 26% of national wealth vs. poorest receive only 2% вЂ“ Rural poverty is almost twice as much as urban (38% vs. 20.4%) вЂ“ Most vulnerable least protected (women and youth, especially in rural areas) Socio-Economic Development (cont.) KAZAKHSTAN - Issues вЂў Population decline - since 1991 population reduced by 1.7 million due to: вЂ“ emigration вЂ“ reduced fertility вЂ“ increased mortality (particularly among men) Turkmenistan is also concerned with population decline Uzbekistan - high fertility in rural areas Socio-Economic Development (cont.) KAZAKHSTAN - Issues вЂў Decreasing health status of population вЂ“ Unhealthy behavior practices вЂ“ Lack of life skills and knowledge of healthy lifestyles вЂ“ Poor attitudes to own health вЂ“ Poor ecology National Population and Development Policies KAZAKHSTAN вЂў National development strategies 2030 and 2010 вЂў Poverty reduction programme вЂў Demographic and migration programme вЂў Rural development programme вЂў National Plan on environment for sustainable development National Population and Development Policies(cont.) Kyrgyz Republic вЂ“ population issues addressed in various documents, but no integrated policy or strategy exists Turkmenistan вЂ“ social protection of vulnerable, environmental and internal migration policies Uzbekistan вЂ“ population issues integrated into development policies and reforms Tajikistan вЂ“ PRSP, environmental policies, internal migration policies Gender Equality, Equity and Women Empowerment вЂў Kazakhstan and republics of Central Asia are the signatories of the ICPD PoA and Beijing Platform of Actions вЂў Legislation and relevant institution established Kazakhstan вЂ“ National Commission on Family and Women Affairs under the President of RK Uzbekistan вЂ“ 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 вЂў Gender differentials in key socio-economic indicators вЂў Gender Stereotyping вЂў Lower carrier perspectives вЂў Reported domestic violence Similar situation in other CA countries Gender Equality, Equity and Women Empowerment(cont.) Gender Violence and Discrimination Kazakhstan вЂў Units combating abuse against women formed in 1999 in the Ministry of Internal Affairs вЂў Network of crisis centers established вЂў 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 вЂў MMR is highest among CA countries вЂ“ 50.5 per 100,000 livebirths вЂў High rate of pregnancy and delivery complications вЂ“ 60% вЂў Causes of maternal deaths вЂ“ Insufficient management of obstetric emergencies (hemorrhages, infections, eclampsia, etc) вЂ“ Abortions вЂ“ Poor health & nutritional status вЂ“ Poor quality of antenatal care Reproductive Rights and Reproductive Health (cont.) Kazakhstan вЂў Contraceptive prevalence rate on rise вЂ“ 50.7 (MoH, 2002) вЂў Unmet need for family planning вЂ“ 8.7% (DHS, 1999) вЂў Access and quality of reproductive health services poor, particularly in rural areas Abortion Trends in Kazakhstan вЂў 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 вЂў Number of abortions per 1000 females in reproductive age decreased by 2.2 times вЂў Number of abortions per 100 births decreased almost twice вЂў 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 вЂў STIs on the rise вЂў Drug abuse: 40,000 officially registered; estimated 250,000 вЂў Smoking: 10% of adolescents under 14 years, 20% under 16 years, and 70% under 24 years. вЂў AlСЃohol: 6% of adolescents under 16 years, up to 80% of under 24s вЂў Reproductive Health: only 20% adolescents under 17 are healthy. 7000 abortions among girls under 17 of which secundigravidae - 53,8% (NHLS, 2003) вЂў 24 HIV positive among adolescents under 14 вЂў 411 HIV positive among adolescents 15-19 years HIV/AIDS in Kazakhstan вЂў Spread of HIV/AIDS in Kazakhstan at a fastest pace among countries of Former Soviet Union вЂ“ вЂ“ вЂ“ вЂ“ 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 вЂў Enacted the Concept Paper and National Programme on Counteracting of HIV/AIDS Epidemic in the Republic of Kazakhstan for 2001-2005. Partnerships Partnerships вЂў UNFPA and other UN organizations, development agencies and donors вЂў Government вЂў Civil Society Best Practices Kazakhstan вЂў Focus on quality of care enabled developing and introducing evidence-based clinical protocols on a variety of reproductive health issues вЂў A continuing series of training for health professionals on modern contraceptive technology, management of STIs and RH counseling by national experts and NGOs вЂў Alliance of the Government with international community and civil society organisations paved the way for introducing population dimensions into development strategies вЂў Community-based distribution of information and services demonstrated its high value as a tool for social mobilization Best Practices Kyrgyz Republic вЂ“ establishment of a community-based Social Patronage System enabled minimizing cases of infant and maternal mortality Turkmenistan вЂ“ advocacy efforts led to introduction of gender issues into sectoral plans Uzbekistan вЂ“ running of a social communication campaign covering a broad spectrum of reproductive health issues Tajikistan вЂ“ participatory approach involving Government agencies, technical expertise and civil society resulted in adoption of Poverty Reduction Strategy Paper Emerging Issues Kazakhstan вЂў Low understanding of reproductive rights among decision-makers may jeopardize development agenda of the country pursuing pro-natalist policy вЂў Lack of national expertise in demography and social statistics exacerbated by data problems вЂў 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. вЂў 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 вЂў The Constitution of the Republic of Kazakhstan as of 30.08.95 according to which the citizens have right to health care вЂў 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: вЂў a woman has right to decide herself the issue on maternity вЂў with a view of healthcare a woman has right to use the modern methods of contraception вЂў maternity in RK is preserved and encouraged вЂў maternity care is ensured by organizing of the wide network of specialized medical organisations, benefit payments on account of childвЂ™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: вЂў the Government protects the rights and interests of children who are to be under medical examination and constant and dispensary observation вЂў Adults must care about childrenвЂ™s health, their physical, intellectual and moral development, to bring up children to the healthy life style вЂў Pregnant women must get registered in maternity healthcare centers вЂў 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 вЂў A person under 18 years old is recognized as a child. вЂў Every child has right to live and be brought up in a family, to know her/his parents. вЂў 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) вЂў At the present time in Kazakhstan exist more than 150 womenвЂ™s NGOs вЂў Republican movement вЂњWomen of KazakhstanвЂќ, Coalition of womenвЂ™s NGOs in operation.