From choice, a world of possibilities The Needs and Challenges of Women’s Sexual & Reproductive Health in Eastern Europe and Central Asia Defending Women’s Rights, P2P Study Tour Brussels, 23 March 2011 Elizabeth Bennour IPPF European Network

IPPF EUROPEAN NETWORK IPPF EN Members in 41 countries in Europe and Central Asia Some of IPPF’s founder members Creation of 21 MAs in post-Soviet Eastern Europe, Balkans and Central Asia

Sexual and Reproductive Health and Rights: What do women want? Sexual health and well being Choice of if/when to have children and how many Safe motherhood Bodily integrity IPPF EN ► Access ► Quality ► Information ► Rights

IPPF EN Contraceptive Prevalence, Modern Methods Choosing if and when to have a child Source: UNFPA, State of the World Population, 2010

Contraceptive Prevalence, Modern + Traditional Methods IPPF EN Choosing if and when to have a child Source: UNFPA, State of the World Population, 2010

Choosing if and when to have a child Source: UNFPA, State of the World Population, 2010

Abortions per 1000 live births % of women trying to delay/ avoid pregnancy % of those trying to delay/avoid who use a traditional method Bulgaria Estonia Hungary Latvia Romania Slovakia Armenia Georgia Kazakhstan Rep Moldova Russia Serbia Link between abortion and reliable contraception Choosing if and when to have a child Sources: UNFPA, State of the World Population, 2010 WHO, European Health For All Database, 2010

Abortions by age group Choosing if and when to have a child Source: WHO, European Health For All Database, 2010

Critical Issues Urban/rural disparities in access to services Lack of knowledge on contraceptives and abortion methods Poor quality of services, particularly counselling on contraceptives Limited use of modern abortion methods in many countries Limited choice of contraceptives High cost of contraceptives Choosing if and when to have a child

Critical Issues (2) Limited access to assisted reproduction ► fertility tourism Choosing if and when to have a child

WHO European Health For All Database, 2010 Safe Motherhood

Abortion-related maternal deaths per 100,000 live births 22%33% 9% 13%32% 29% Safe Motherhood Source: WHO, European Health For All Database, 2010

Chlamydia – Incidence rate/ population Source: CISID Sexual & Reproductive Health and Well Being

IPPF EN Sexual & Reproductive Health and Well Being HIV among women Increasing proportion of women “Blame”, stigma, discrimination In some countries effectively denied right to have children % of total infected who are women Source: WHO, European Health For All Database, 2010

Source: WHO MDB, latest available data Sexual & Reproductive Health and Well Being Cervical cancer mortality in selected European Countries

IPPF EN 20-65% of women have experienced violence of intimate partner 70,000 new victims of trafficking in Europe each year 140,000 currently trafficked ► close link between trafficking and GBV Bodily Integrity Gender Based Violence (GBV) and Trafficking Other violations of bodily integrity: FGM Honour crimes Forced marriage

IPPF EN Critical Issue: Comprehensive Sexuality Education Essential for young people to have healthy and fulfilling sexuality Not mandatory in all countries (very controversial in some) Many variations between and within countries on: Starting age and duration Quality of teaching and teacher training Quality of materials Breadth of content: very often narrow (biological) and negative Good materials and guidelines exist: we need to advocate for them

IPPF EN Thank you!