Reproductive Health

After the approval of the first Country Programme in September 1999, three Sub-programme documents were developed: the Reproductive Health, the Population Development Strategies, and the Advocacy Sub-programmes. All three Sub-programme documents included various activities and aspects related to advocacy, gender equality and IEC, although the overall IEC part had been included in the RH Sub-programme.

A Country Population Assessment (CPA) udertaken in 1998 identified various reproductive health issues, such as the need for a demographic health and survey to generate reliable information on reproductive health status, use of RH services and attitudes to RH issues among men and women, the contraceptive prevalence and method mix;

The need for improving the contraceptive logistics systems (including procurement, supply and distribution system); the need to extend choices of contraception; the need for training providers in the rational use of contraceptives - including competency based training in clinical contraception and counselling skills; the need for the revision of clinical 'norms and standards'; and, the need for IEC in order to create a demand for family planning services and for reasonable use of maternal health care and services for reproductive tract infections, including STDs and HIV.

The RH Sub-programme was developed with considerable involvement of partners from the Ministry of Health and Medical Industry and in particular the Maternal and Child Health (MCH) Institute and to a lesser extent the Ministry of Education.

A National Reproductive Health Strategy was prepared in 2000 and has been influential in deciding the content of the national law on "Protection of Health of the Citizens" adopted in December 2002 and published in January 2003 . The Health Reform Office has been supported mainly through training provided to central and velayat health managers of whom around 200 have received training on specific topics on several occasions, most importantly on the benefits of integrating RH into primary health care. Consultancies have been provided mainly through the WHO-executed part of the project to advise about specific health reform issues .

Training of key RH service providers for improving their communication skills had reportedly also been carried out.

"Adolescent reproductive health (ARH) cabinets" have been equipped and established in five velayat a nd ashgabat city RH centres.These clinics have staff trained in the particular health problems of young people.Training of master trainers on medical and social aspects of adolescent health was undertaken with WHO assistance in 2002 and subsequently training of staff working at the ARH cabinets has been carried out.

Additional activities have been included in the RH services project covering 2003 to 2005. For instance, support has been provided for "male involvement" in RH issues. This specifically involved equipping of cabinets at six dermato-venereology hospitals in the country (one in each velayat and one in Ashgabat) and training in each of one doctor in male counselling and in providing IEC for the prevention of STIs.

The RH Sub-programme's contribution towards the Goal "to have contributed to the improved quality of life of the people of Turkmenistan through improvements in reproductive health …" is undeniable as UNFPA has been the major donor in RH in Turkmenistan during the last five years. The provision of RH services through the newly established RH centres has been essential in providing RH information and services - particularly contraceptives - to a substantial proportion of the population. The utilization of the RH services has steadily increased over the five years of the CP.

Within the new programme cycle for 2005-2009 UNFPA will continue to support Reproductive health facilities in the provision of integrated reproductive health services including family RH, ARH services, male RH services, safe motherhood, STI/ HIV/ AIDS prevention, prevention and treatment of breast and cervical cancers at early stage of the diseases and capacity building of service providers, including family physicians and nurses. The latter will facilitate the further introduction of reproductive health services into primary health care level. Special attention will be placed on ensuring that reproductive health programmes are gender sensitive and development of client-oriented minimum service standards.

There are two CP otcomes which fall under the RH programme component. First is to have more women, men and adolescents use client-oriented reproductive health services and have access to reproductive health-related information at all levels. Second s safer behaviour to prevent HIV/AIDS is adopted by youth, adolescents, refugees and other vulnerable groups.

UNFPA will continue to support Ministry of Health and Medical Industry, mainly, to strength the Reproductive Health facilities in the provision of integrated reproductive health services including safe motherhood, HIV/ AIDS prevention, STI prevention and treatment, ARH services, male RH services and capacity building of service providers, including oncology specialists, family physicians and nurses. In order to improve the quality of care, UNFPA will support the development and introduction of modern guidelines and clinical protocols for the mentioned services. In addition UNFPA will support the Ministry of Health and Medical Industry in further introducing reproductive health services into the primary health care level. UNFPA will partner with Ministry of Health and Medical Industry in procurement of Reproductive health commodities at national level and in distributing them to reproductive health facilities at all levels.

The Ministry of Health and Medical Industry will make the following crucial contributions by providing human resources and both physical and organizational infrastructure; Moreover, Ministry of Health and Medical Industry will seek the possibility to establish a complementary fund to support reproductive health programmes.

UNFPA will support the preventive component of STI/ HIV/ AIDS jointly with other UN agencies. Specifically, UNFPA will continue condom supply, training of service providers and conducting IEC campaigns for increasing public awareness, particularly among youth. For this reason, UNFPA will work with service providers at the reproductive health facilities, STI/ HIV/ AIDS centres, youth organization and Women's Union.

The special needs of young people, including ARH issues, will be addressed in collaboration with civic organizations, particularly Women's Union and Youth Organization, whereas efforts will be made to work with newly established Information-Resource Centers of these two organizations of Turkmenistan. The further expansion of the RH lessons for 9th grade students of the national schools will be conducted by the Ministry of Education of Turkmenistan.

The dissemination of reproductive health and population information will be done in collaboration with the Ministry of Health and Medical Industry, the Ministry of Education, Youth Organization, Women's Union and the Ministry of Social Welfare.