By Naomi Kitahara, UNFPA Representative
In this era of the 2030 Sustainable Development Agenda, our world needs to address both economic and social inequality if we are to achieve the Sustainable Development Goals. While economic gaps between countries are generally narrowing, they are growing within many developing countries, threatening to destabilize societies and undermine development.
Nearly one in three people in Mongolia fall below the poverty line, but it is important to point out that inequality is not just about money, wealth or income. It has many other dimensions such as power, rights and opportunities that either reinforce or are reinforced by economic inequality in a vicious cycle.
One key dimension of inequality that should receive deeper attention, but is often ignored, is inequality in women’s reproductive health and rights. For instance, only one in five women from the poorest 20% of households in Mongolia have access to good quality antenatal care services, while for the wealthiest 20%, more than one in two women receive these critical services. In other words, rich Mongolians are enjoying good health care during pregnancy and childbirth, while poor Mongolians are not.
Reproductive rights are fundamental human rights. Without them, women and adolescent girls are at risk of unplanned pregnancy. When pregnancy is not planned or wanted, it can set in motion a lifetime of missed opportunities and unrealized potential, trapping a woman, her children and future generations as well in a cycle of poverty that is difficult if not impossible to break out from.
When adolescent girls and women are able to take charge of their fertility, they can finish their education, enter the paid labour force and gain more socio-economic power. This sets the foundation for health and well-being through adulthood and then into old age. Thus, access to reproductive health care and services and the ability to claim and exercise one’s reproductive rights truly helps women and girls realize their full potential.
It is extremely troubling that as per recent studies, 14% of pregnancies in Mongolia end in abortion. This tells us that women’s needs for modern contraception are not being met in the country.
Faced with unplanned and unwanted pregnancies, individuals and couples, in desperation, often turn to unsafe methods to terminate the pregnancy, leading to pregnancy complications and maternal deaths. It should be noted that from 2012-2015, almost one in ten preventable maternal deaths were due to unsafe abortion.
An effective way to break this needless cycle is to ensure the provision of comprehensive sexual and reproductive health information, care and services, particularly modern contraceptives and family planning education. A sufficient state budget needs to be allocated to provide contraception and family planning counselling services to women and men in the country, particularly to Mongolia’s youth at productive and reproductive age.
On a related note, the de-legalisation of abortion has not proven an effective solution globally. The government of Romania, for instance, severely restricted the practice from 1967 to 1990, in order to increase fertility within the country. This ultimately led to the highest maternal mortality ratio in Europe at approximately 150 maternal deaths per 100,000 live births. The case of Romania must be avoided.
Women and their families across Mongolia should be having their children by choice and not by chance. They have the right to plan the timing, spacing and number of children they wish to have. If a country truly aims to strengthen families and encourage its people to have children, a rights-based approach with empowerment and choice at the core, is the only way. Such an approach must ensure that mothers are safe in pregnancy and childbirth, and babies are born healthy. Measures that enable individuals, couples and families to manage the economic challenge of having children are also necessary, as is the need for gender equality and parity in the household, with women and men sharing responsibilities for raising children and housework, to ensure an optimal scenario.
We at UNFPA propose the following three courses of action for Mongolia:
1. Implement comprehensive sexuality education – which goes beyond sex education and serves as a foundation for life -- within all formal and non-formal education sectors;
2. Readily make available reliable, modern contraceptives with different choices to all who need and want them, including women and young people; and
3. Support and invest in sexual and reproductive health services, including family planning,that are client-friendly and staffed by trained professionals.
Bringing the worlds that are currently apart in Mongolia closer together will not be easy, but it is feasible. Tackling inequalities in sexual and reproductive health, reaching the furthest behind first, is a good place to begin.
About the author: Naomi Kitahara is the UNFPA Representative in Mongolia, with more than 20 years of international development experience. She is a passionate advocate for gender equality and women’s empowerment.