Statement

Statement by Naomi Kithara at the "National Consultative Meeting on Reproductive Health and Family Planning"

18 6-р сард 2018

Honorable State Secretary of Health Mr. Sodnomjamts, Directors of Health Departments and Hospitals of Ulaanbaatar city and aimags; representatives from the National Center for Maternal and Child Health, and maternity homes; representatives from professional and civil society organizations; ladies and gentlemen:

The United Nations Population Fund in Mongolia is honored to host – together with the Ministry of Health – the National Consultative Meeting on Reproductive Health and Rights. I am very pleased to learn that this event will be held annually, creating a formal mechanism that enables all of us to discuss emerging concerns around sexual and reproductive health, including maternal health, family planning, prevention of sexually transmitted infections, adolescent and youth-friendly services and more.

Mongolia has been widely acknowledged as one of the only nine countries in the world which achieved in 2015 the maternal health target of the Millennium Development Goals. However, in the very next year in 2016, we witnessed the Maternal Mortality Ratio doubled from 2015, indicating the fragility of the health system in Mongolia. This raises a question: What are the strategies we need to adopt to sustain our achievement and further reduce maternal deaths in the long term?

Based on strong international evidence, UNFPA is certain that these strategies may very well be:

·      Firstly, there is a need for provisions on comprehensive emergency obstetrics and newborn services;

·      Secondly, we need to look at the repositioning of family planning; and

·      Finally, further investment is required in young people in the area of sexual and reproductive health and rights. 

If we compare the Social Indicators Sample Survey data between 2013 and 2016, unmet need for family planning has increased from 15 to 21 percent at aimag level, and from 17 to 27 percent in Ulaanbaatar. Amongst young women between the ages 20 to 24 in Khuvsgul aimag, for instance, unmet need is as high as 31 percent. It means that even if couples want to access and use contraceptives, they are not able to do so.

Two weeks ago, during my visit to Arkhangai aimag, I was impressed with the excellent improvement of maternal health services in the province. However, I was also informed that in 2017, only 15 doses of injectable contraception was provided to a soum with 5,000 population, which would only cover annual contraceptive needs of 4 to 6 women. With this experience in mind, how will poor women, marginalized women and isolated women be able to access contraception when they cannot afford them? How do we ensure that no one is left behind from these essential services? We have estimated that across the country, there is a severe shortage of contraceptives at the moment, and only a portion of the contraceptive needs seems to have been secured so far.

At UNFPA, we strongly believe that family planning is fundamental for reducing maternal deaths. Just as vaccinations prevent children from dying, contraceptives can prevent women from dying. When women are in control of their sexual and reproductive health, unplanned pregnancies, unsafe abortions and high-risk pregnancies can be avoided.

In UNFPA’s recent study on social budget analysis, it was estimated that for every MNT 1,000 we invest in the supply of modern contraceptives, we save MNT 3,200 of the cost of pregnancy-related care and services. This means in annual terms, we will be saving millions of dollars from the state budget if a sufficient budget allocation is done to ensure the uninterrupted supply of modern contraceptives across the country.

Also, last week UNFPA and NSO launched Mongolia’s very first study report on gender-based violence, “Breaking the Silence for Equality”. It revealed some shockingly high rates of violence against women in Mongolia. It also clearly showed the linkage between violence against women and girls and its negative consequences on women’s reproductive systems. In many cases, such violence even led to maternal deaths. As such, I would like to encourage every participant here present today to also discuss the issue of gender-based violence within the context of improving the sexual and reproductive health status of Mongolia’s population.

I would like to congratulate the Ministry of Health for its leadership in allocating 350 million tugrugs for contraceptives in 2018, and UNFPA will be very happy to facilitate the procurement process, ensuring the best value for money. For future years, however, we would like to encourage additional resource allocation by the national government so as to fully meet the needs for family planning as well as to provide budgets to support victims of violence. I would also like to encourage local authorities to invest more on contraceptives and care required for victims of domestic violence.

I wish you all a very fruitful consultation.

Thank you