reproductive health inequalities · 2017. 11. 7. · (lifetime preva-lence, %) 100% 2007 2012...
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REPRODUCTIVE HEALTH INEQUALITIESin Eastern Europe and Central Asia
Ten of the world’s 25 most equal countries are in Eastern Europe and Central Asia.
Tajikistan: dramatic widening of inequalities between rich and poor in access to ante-natal care
Moldova and Serbia: Poorest women left behind
Reducing ante-natal care inequalities: the Armenia success story
Antenatal care coverage: at least four visits
“Inequalities in sexual and reproductive health and rights have costs to the individual, the community, nations and the entire global community.”
UNFPA, State of World Population Report 2017
But: huge inequalities in reproductive health - among and within countries
LESS EQUAL
Belarus Kyrgyzstan EU average
MORE EQUAL
Women in the region are still dying during child birth, and differences
in maternal mortality rates between countries are enormous.
Women and girls with disabilities face particular difficulties in exercising their
reproductive rights, as a result ofstigmatisation and discrimination.
Armenia in 2008 almost doubled budget allocations for maternity care and in-
troduced certificates entitling pregnant women to free services. As a result,
women in all wealth quintiles now have better access to services than they had before, and previous inequalities have
largely been erased.
Generally, around 90% or moreof pregnant women in the region
get a minimum of four check-ups. But wealth, ethnicity and place of residence still impact the level of
care women get.
HIV is on the rise in theregion, with 190,000
new infections every year,generally affecting
men more than women.
Contraceptive choicesand use of modern methods
vary widely in the region.Usage rates are extremely
low in Southeastern Europe and the Caucasus,
and generally higher in Central Asia and Eastern Europe.
Gender-based violence iswidespread in the region
and affects mostly womenand girls. It undermines thehealth, dignity, security and
autonomy of its victims,and can affect their sexual
and reproductive health.
“Pulling a world that is apart closer together will not be easy, but it is feasible.”
Across the region, young women under 20are far less likely to use modern contraceptives than their older peers.
Wealth also affects the useof modern contraceptives:
The gap in usage rates betweenthe poorest and wealthiest
women in the region is
INCOME INEQUALITY: LOW
ADOLESCENT PREGNANCY
ANTE-NATAL CARE
HIV
MODERN CONTRACEPTIVES
GENDER-BASED VIOLENCE
GENDER INEQUALITY
1
5
3
7
4
9
8
0
40
20
60
80
100
MATERNAL MORTALITY
WOMEN WITH DISABILITIES
2
6
Income inequality (as measured by the GINI index)
Ante-natal care: Roma vs general population
Ante-natal care: urban vs rural
Turkey and Tajikistan:less access for rural women
Source: MICS, DHS, or other national surveys. All figures in this section express the percentage of pregnant who have had access to a minimum of four ante-natal check-ups.
UNFPA, State of World Population Report 2017
0
50
100
% of women of reproductive age, married or in union Source: UNFPA, State of World Population Report 2017
Source: Turkmenistan MICS 2015-16. Percentage of women married or in union women who are using modern contraceptives
Use of the modern contraceptives
percentagepoints
10Source: UNFPA, State of World
Population Report 2017
Source: UN Population Division, World Population Prospects.
Source: Reproductive Health Training Center, Situation analysis, 2016 (focus group study)
Source: UNAIDS. Data available for 10 countries in the region.
Source: OECD
Source: UNFPA EECARO, based on national surveys
Source: UN Women, The World’s Women 2015. Only countries in theregion with recent data are listed.
Source: MICS
Adolescent birth rates are going down, except in Azerbaijan, and gaps
between countries have been shrinking. But the regional rate is still 3x higher than in the EU, as young people face
barriers accessing information and
services.
among Roma minorities
Moldova: physical and attitudinalbarriers to access to to sexual
and reproductive health services
Rate of new infections is Number of men living with HIV is
and in rural areas
Azerbaijan
European Union
Bosnia and Herzegovina
among young Roma women*
in Serbia
38%among young rural women*
in Moldova
6%among all
young women*in Serbia
1%
women with disabilitiesreport physical access
barriers
over 1 in 2
higher among men than among women (2015)
1.4 xhigher than number of women
living with HIV (2015)
1.5 x
women with disabilities report unfriendly or accusatory attitudes
by medical personnel
1 in 3
among young urban women*
in Moldova
3%*women aged 20-24 who gave birth before age 20
Gender inequalities have a direct impact on women’s ability to realise their
reproductive rights. Although inequalities are relatively low in the region, and are
decreasing, differences between countriesremain significant.
Gender inequalities are on the decline in the region
Measuring discrimination against women in lawsand social norms and practices
Source: UNDP Gender Inequality Index. The Index measures gender inequalities in health, education and political and labour force
participation. Average for the countries in the region.
0.47 0.271995 2015
1 - High inequality 0 - Low inequality
“We all gain when human rights and dignity are universally upheld,with no exceptions and no one left behind”
Psychological violence
Physical violence
Sexual violence
Albania
Bulgaria
Kygyzstan
Romania
Tajikistan
Turkey
10
20
30
40
50
60
WesternBalkans
Eastern Europe
South Caucasus
CentralAsia
0 5 10 15 20 25 30 35 40
This data sheet provides a few snapshots of reproductive health and gender inequalities in Eastern Europe and Central Asia. It supplements UNFPA’s 2017 State of World Population Report. The report is available at unfpa.org/swop
Delivering a world whereevery pregnancy is wantedevery childbirth is safe andevery young person’spotential is fulfilled
United Nations Population FundRegional Office for EasternEurope and Central AsiaIstanbuleeca.unfpa.org
0
10
20
30
40
50
60
70
Rus
sian
Fed
erat
ion
Tur
key
Geo
rgia
Bul
gari
a
Bos
nia
and
Her
zego
vina
Arm
enia
Taj
ikis
tan
Serb
ia
Alb
ania
Rom
ania
Bel
arus
Mol
dova
Kyr
gyz
Rep
ublic
Kaz
akhs
tan
Ukr
aine
Wor
ld a
vera
ge
Deaths per100.000 live births
4
76
8
0
50
100
Pregnant Romawomen are lesslikely to get ante-natalcheck-ups
Access to ante-natal care is more limited for women in rural areas in some countries
Serb
ia
Kos
ovo
(UN
SCR
124
4)
Kos
ovo
(UN
SCR
124
4)
(Rom
a)
Bos
nia
&
Her
zego
vina
(R
oma)
Bos
nia
&
Her
zego
vina
Serb
ia (
Rom
a)
Uzbekistan
Bosnia &Herzegovina
Regional average
EU average
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Teenage birth rates remain very high
UNFPA, State of World Population Report 2017
0.00
0.02
0.04
0.06
0.08
0.10
0.12
0.14
0.16
0.18
0.20
0.
0.
22
0.
Alb
ania
Aze
rbai
jan
Arm
enia
Geo
rgia
kyrg
yzst
an
Uzb
ekis
tan
Tajik
ista
n
FYR
Mac
edon
ia
Kaz
akhs
tan
Turk
ey
Ukr
aine
Rom
ania
Mol
dova
Bul
gari
a
Bel
arus
Serb
ia
OEC
D
Bos
nia
and
Her
zego
vina
Lifetime prevalence (%) of intimate partner and domestic violence, by subregion and form of violence.
Physical intimate partner violence(lifetime preva-lence, %)
100%
2007
2012
Moldova 2012
Serbia 2014
100%
2005
2015/16
Poorest
Poorest
Richest
Richest
100%
Turkey 2013
Tajikistan 2012
urbanrural
0
50
40
30
20
10
60
70 Turkmenistan: Low modern contraceptive use among the young
Under 20 20-24 25-29 30-34 35-39 40-44
0
20
40
60
80
100
1992
1993
1994
1995
1996
1997
1998
1999
200
0
200
1
200
2
200
3
200
4
200
5
200
6
200
7
200
8
200
9
2010
2011
2012
2013
2014
2015
Adolescent fertility rates (births per 1,000 women ages 15-19)
Very Low
LowM
oderateH
igh
Source: World Bank. Data covering 2011-2014, latest available figure.
Source: Trends in maternal mortality: 1990 to 2015. WHO, UNICEF, UNFPA, World Bank & UN Population Division
26
24Social Institutions and Gender Index
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rt K
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©V
lad
And
reev
Kos
ovo
(UN
SCR
124
4)