Liberalising Access to Abortion and Sex Education to Decrease Teenage Pregnancy in Kazakhstan
Teenage pregnancy rates in Kazakhstan are high, with 3443 births in 2017, much higher than during the Soviet period. As a means to decrease the prevalence of teenage pregnancy, the Vice Minister of Healthcare has proposed a more liberal abortion regime by making abortions more accessible to teenagers, providing access to birth control and introducing sex education at schools.
The current legislation allows for the termination of pregnancy for persons aged 18 or over and for adolescents who have their parents’ consent. This has forced many young people to resort to illegal and unsafe abortions or abandon their new-born children. According to the proposed changes, teenagers would no longer need their parents’ or guardians’ permission to receive counselling or abortion services from the age of 16. The proposed legislative changes are supported by the Convention on the Rights of the Child, especially General Comment No. 15 (2013) on the right of the child to the enjoyment of the highest attainable standard of health (art. 24). This provides that teenagers should have a right to seek confidential medical counselling without parental consent, including in the context of accessing safe abortions.
The suggested changes have been the subject of heated debate among local experts. Proponents of the legislative changes argue that the failure to provide access to safe abortion services for teenagers has had and will continue to have harmful health consequences. Further, some experts contend that teenagers seeking medical counselling or abortion hide the signs of their pregnancy from their parents due to the fears of judgement, placing themselves at risk of health complications without parental support. On the other hand, it has been argued that the proposed reforms would encourage early sexual activity and increase, rather than prevent, unwanted pregnancies. Another concern is that private clinics would profit from the reforms. Thus it has been suggested that the abortion services should only be accessible in free public hospitals. Organisations such as TEENS: All about Teenagers Project, have been in support of sex education as an important tool to eliminate teen pregnancies. The proposed amendments will be helpful. However, without changing cultural norms related to sexual and reproductive health, they may not be effective in reducing teenage pregnancy.
Local research has found that the root of the high rate of teenage pregnancy is related to a low awareness about sexuality among Kazakh teenagers, particularly those residing in southern and rural areas. Another factor is the inaccessibility of health services. The Kazakh Ministry of Information and Communications’ Central Communications Service has suggested that young people in Kazakhstan tend to ignore their reproductive and sexual health. Those who are aware of sexual and reproductive health issues, are not able to use contraceptive methods because they are not affordable. Access to contraception for teenagers is also curtailed by the behaviour of healthcare providers, who are unwilling to sell contraception such as condoms to teenagers. This is due to the social stigma attached to early and non-marital sexual activity, especially in rural areas.
According to UNICEF 70% of 10-17 year olds in Armenia, Bulgaria, Kazakhstan, Romania and Ukraine, would prefer to apply for medical abortion and counselling services without their parents’ consent. This happens because they are likely to encounter non-acceptance or rejection by their parents if they talk about their pregnancies or sexual activity. This shows that in addition to the suggested reforms, more needs to be done to change social attitudes about sex and sexual and reproductive health.
While it might not be possible for the government to address all the root causes of the high rate of teenage pregnancy, there are some interventions that could be taken. First, the international community, policy-makers and the public should combine efforts to reduce stigma through public awareness and information campaigns in the native language. This will hopefully help in changing social norms around sexual and reproductive health and encourage more parental involvement in the sexual and reproductive healthcare of children. The Government should also make efforts towards decreasing sex crimes rates in the country as some unwanted pregnancies are a result of rape. These, together with the suggested reforms, may help make strides towards reducing unwanted teenage pregnancy in Kazakhstan.