Family planning for large families in the Kyrgyz Republic
This was the woman's second trip—and second abortion—to the clinic in Jalalabat in seven months. When she received counseling her about her family planning options after the abortion, the woman was thrilled at the long-term nature of the IUD, saying "You mean I don't have to worry about becoming pregnant for twelve years?"
Clearly, this woman had an unmet need for a long-term, or permanent, method of contraception. She was fortunate to come to Jalalabat when JSI was conducting the IUD training and the contraceptive supplies that she wanted—and so plainly needed—were available to her free of charge.
Unfortunately, this woman's story is common throughout the Kyrgyz Republic and much of rural Central Asia. When the trainees discussed her situation, they were, sadly, all too familiar with her story. They see many such women in their practices. Because long-term and permanent contraceptive methods are not widely available in rural areas, women either resort to abortion, or have more children than they intend.
In Central Asia, the linkages between complementary women's health services and family planning are not strong, resulting in lost opportunities for women who want and need contraception. Outdated clinical practice guidelines mean that many women are denied IUDs immediately postabortion. National guidelines call for extensive (and unnecessary) medical tests and examinations prior to IUD insertion, which means that women face a waiting period and unnecessary costs prior to finally obtaining their IUD.
To address these weaknesses in reproductive health services and family planning, JSI's Regional Activity offered a postpartum/postabortion IUD training of trainers activity in Jalalabat, Kyrgyz Republic for health practitioners from the Kyrgyz Republic and Tajikistan. The objectives of the training were to increase participants' knowledge about safe, evidence-based postpartum and postabortion IUD insertion, develop clinical skills to perform IUD insertions, and train them to teach other practitioners to perform this procedure safely and effectively.
After the training, participants agreed how important it is to make family planning methods available to women when they are seeking related reproductive health services. The 30-year old Kyrgyz mother's experience simply underscored the importance of their work, the need to extend this kind of training throughout the region, and their sense of urgency and commitment to help expand complementary family planning services to their home facilities.
This need was quickly proven when, in the maternity hospital where the training was held, postpartum IUD insertions were nearly 3.5 times higher three months after the training compared to three months before the training. With proper training, supplies, and equipment, providers are working to make complementary family planning services widely available to their clients who need them.
|Related Project: Europe & Eurasia Regional Family Planning Activity (2006-2009)|