Helping to improve Reproductive Health in Turkey

What's the situation?

There can be no doubt that Turkey has made progress in improving reproductive health. In line with the 1994 International Conference on Population and Development (ICPD) , the rates for maternal and infant mortality have dropped and the prevalence of contraception has grown.

However, as with all aspects of development in Turkey, there are still considerable disparities between the quality and access to services for people who live in rural areas as opposed to towns and cities and for people who live in the poorer east of Turkey rather than the west. There is also a lack of reliable data on key issues such as maternal mortality.

Despite some progress achieved in the area of primary mother-child health care and reproductive health, there are serious gaps in the availability of health care services, particularly between urban and rural areas and among the regions. Access to quality family planning services needs to be increased.

Limited access to RH services, low use of modern contraception

Access to reproductive health (RH) information and services in Turkey is still limited, particularly for men, young people and disabled people.

There is also a clear need to improve obstetric services . This can be seen from Turkey's perinatal mortality rate (this is the sum of the number of the stillbirths and early neonatal deaths divided by the number of pregnancies of seven or more months' duration) According to the Turkish Demographic and Health Survey (2003), the perinatal mortality rate in Turkey is 24 per thousand (in rural areas 29 per thousand), which is high when compared to developed countries.

Compared with many neighboring countries, overall contraceptive prevalence in Turkey using both traditional and modern methods) is high, at 71 percent, according to the 2003 Turkish Demographic and Health Survey. However, only 42.5 percent use modern contraceptives. There is still a heavy reliance on traditional methods and this leads to many unplanned pregnancies.

Although there has been a drop in the percentage of pregnancies which are ended through induced abortion, the level is still high. T he use of post abortion contraception and post-partum contraception is quite limited.

An additional and important challenge for Turkey is the p revention and early diagnosis of sexually transmitted infections (STIs) . Surveys on young people and sexually active adults indicate a dangerous lack of knowledge about STIs other than HIV/AIDS .

Little education, few services for young people and adolescents

With all of the reproductive health issues outlined above, young people and adolescents are particularly vulnerable.

In Turkey, although Health Education does take place in the current primary and high school curricula, it is not enough to equip pupils with the knowledge and skills they will need to manage their own reproductive and sexual health. Where courses are available, they rarely focus directly on changing attitudes and behaviors and the teachers required to give the courses may not themselves have up-to-date resources.

Research shows that at present, young people in Turkey mostly get information about sexual and reproductive health from their friends, magazines and newspapers. Such inconsistent sources put young people at a greater risk from sexually transmitted infections including HIV/AIDS or from unwanted pregnancies.

Although university students are offered free healthcare, usually in special medical centers within the college, these centers do not provide reproductive health counseling or services. . Since university students already are, or soon will be sexually active, it is expected that integrating the provision of RH services into these existing services will have a positive impact on their sexual health and behavior.

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