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Gynaecological

Articles by Gynaecological

Marine and her husband struggled to afford abortion care
08 March 2019

Affordability, stigma and discrimination major hurdles to abortion care

High costs a major barrier, especially for women in vulnerable situations The cost of abortion can be a major challenge for women in Georgia. “Abortion is quite expensive – between 100 (EUR 33) and 500 lari (EUR 163). The average income in Georgia is 600 - 800 (EUR 196 - 262) lari, so it’s a big chunk of a monthly salary. Some people can’t afford it. Abortion is not covered by the national health care system, not even for socially vulnerable people,” says Ana Iluridze, Head of the Gender Equality Department at the Public Defender's Office of Georgia. Abortion is supposed to be available free of charge to survivors of sexual assault, but bureaucratic measures mean that in reality most aren’t able to access this. Disturbingly, those at the very top of power in women’s sexual and reproductive health do not seem to be aware that affordability is a barrier. When questioned about the cost of abortion care, Georgia’s Deputy Minister of Health Maia Lagvilava appeared to think it was financially accessible to most women: “The services are available… and the population has private insurance as well. The services are offered,” she said, adding the caveat that she wasn’t actually sure if abortion was covered under private insurance in the country. Stigma and discrimination prevent free and safe reproductive lives Stigma and discrimination against women’s reproductive freedom is high in the country, especially for those seeking abortion care. Women are forced to travel great distances, sometimes at crippling expense, to try to keep an abortion secret from their community. One of the major issues is that "women’s sexual and reproductive health is taboo in Georgia,” explains Nino Shurgaia, a youth leader with IPPF member HERA XXI in the city of Senaki. When trying to research access to abortion care in the region she found time and time again that families were not willing to discuss the matter, and many feared what their community would think: “They are afraid that their neighbours or family will find out that they had an abortion. They were worried the information they share with me would be leaked,” she says, adding that often during private interviews she set up as part of the research, a mother-in-law or husband would interrupt and start asking what they were talking about. Indeed, community pressure and social stigma mean that women struggle to live free and safe reproductive lives. One woman described feeling as though ending a pregnancy was her only option because “I was worried what people would think… It wasn’t a problem for me to have a child out of wedlock, but it would have been a problem in my community.” Read the next blog in our series on obstacles to abortion care and women's reproductive freedom in Georgia. Main photo: Marine is from a small village in southwestern Georgia, near the city of Akhaltsikhe. Affordability was a major challenge when she and her husband needed to access abortion care: “We were still young and my husband’s income wasn’t high. We couldn’t cover the cost of abortion with our salaries.” Credit: Jon Spaull/IPPF EN

Because of high costs, some women like Natela go years between visiting the doctor
08 March 2019

A plethora of barriers to women’s reproductive freedom

Women in Georgia face many challenges in accessing sexual and reproductive health care.   For starters, many live in rural communities where job opportunities are limited and poverty is high. Here, access to healthcare is complicated because clinics are few and far between. Public transport is scarce and, when available, expensive. Some women, like Natela, a woman living in a rural area near Signagi, a tiny town in the eastern region of Georgia, go years between visiting the doctor, and when they do it is only for emergency treatment. “It’s been 10 years since I last went to the doctors… it’s terribly expensive so now I don’t go,” she says. Natela visited the doctor for abortion care 10 years ago because, without access to contraception, she faced an unintended pregnancy and could not afford to have another child. The government neglects to provide young people with sexuality education in school, and many people have been denied information about family planning. 45 year-old Tamar (not her real name), a woman living in southwest Georgia, says that before her first abortion, “I couldn’t even recognise a condom, it was something very alien.” Contraceptive care is rarely accessible for people living in remote regions, and it is not free: many women simply cannot afford it. Irina Pshenichnaia, a gynaecologist working at a partner clinic of IPPF member HERA XXI in Senaki, a town in western Georgia, says that even when women manage to access contraception, the state’s failure to ensure education and information mean that they don’t always know how to use it correctly: “One woman was taking the pill three times a day because her friend told her to,” she says. Read the next blog in our series on obstacles to abortion care and women's reproductive freedom in Georgia. Photo credit: Jon Spaull/IPPF EN  

countdown logo
12 February 2018

Countdown 2030 Europe

IPPF European Network is the lead partner of C2030E, a consortium of 15 NGOs working to ensure the advancement of human rights and investment in family planning in the Global South. In European countries and within the EU institutions, Countdown 2030 Europe holds donors to account for their policy and funding commitments to achieving universal access to sexual and reproductive health. www.countdown2030europe.org   

countdown logo
12 February 2018

Countdown 2030 Europe

IPPF European Network is the lead partner of C2030E, a consortium of 15 NGOs working to ensure the advancement of human rights and investment in family planning in the Global South. In European countries and within the EU institutions, Countdown 2030 Europe holds donors to account for their policy and funding commitments to achieving universal access to sexual and reproductive health. www.countdown2030europe.org   

18 February 2014

Pro choice victory in Switzerland

Last week in Switzerland a clear majority of voters (69.8%) rejected a conservative initiative that aimed at limiting equal access to abortion.  The proposed initiative would have excluded abortions from the healthcare reimbursement plan, making greater barriers to women and girls, especially women with limited economic means. All women should have access to reproductive health care, including pregnancy terminations, regardless of their economic status. However, discriminative restrictions on reimbursement plans make abortion services an unavailable choice for many low-income women, creating further inequality. Last week’s pro choice victory reaffirms the vote of 2002, when the overwhelming majority of Swiss voters supported a change in the legislation. This granted women abortion on request within the first 12 weeks of pregnancy and later in pregnancy for medical reasons. By rejecting the conservative initiative, Swiss voters have shown that they will not accept any backward steps when it comes to women’s rights and reproductive health.

aaron-burden-xG8IQMqMITM-unsplash_2.jpg
30 November 2017

Photo Gallery: Rising HIV numbers and funding cutbacks - Macedonia at the crossroads

This article was written in September 2017. Since then, thanks to the work of NGOs including our member HERA, Macedonia’s government has committed to providing long-term funding for all HIV programmes for marginalised people. Although HIV prevalence is low in Macedonia, with only 151 people registered as living with HIV, these small numbers mask a complex picture, and one that is rapidly changing. In 2016, there were 40 new HIV diagnoses, the majority of them among men who have sex with men.  Macedonia is not alone in facing a rise in HIV cases. In many parts of Central and Eastern Europe, the rate of new infections is growing. Between 2010 and 2015, the region saw a 50 per cent rise in new HIV infections annually. Another looming problem that threatens to send Macedonian HIV rates spiralling upwards is a funding crisis precipitated by donor cutbacks and political uncertainty. Between 2004 and 2016, Macedonian HIV programmes received almost $25 million from the Global Fund to Fight AIDS, Tuberculosis and Malaria. Much of this money was channelled into HIV prevention, funding NGOs that target those deemed most vulnerable to infection – sex workers, people who inject drugs, men who have sex with men and prisoners. But in 2016 this funding was phased out and NGOs on the frontline are left hoping that the new government will deliver fully on a recent commitment to step in with similar levels of funding in 2018. In the chasm left by the country’s public healthcare system, Macedonia’s sexual health and rights NGOs work tirelessly to plug the gap, often on a shoestring and in an increasingly uncertain funding landscape. HERA, IPPF's member in Macedonia, is a leading NGO providing free HIV testing services, sexual health support and advocacy. It works closely with smaller organisations around the country to ensure support for young people, sex workers, people who inject drugs and men who have sex with men. These NGOs are many people’s first port of call for HIV tests and other vital health care.  

Strengthening the Right to Access to Contraceptives Choice for People with Low Income. Pro familia launches petition to be presented to the German parliament.
12 March 2015

Strengthening the Right to Access to Contraceptives Choice for People with Low Income

Pro familia launches petition to be presented to the German parliament If you do not have much money in Germany, there are a lot of things you have to go without. When that includes contraceptives, it can be disastrous. Studies show that women change their contraceptive behaviour when they are in financial need: they switch to cheaper and less reliable forms of contraception or use no contraception at all, thus risking an unwanted pregnancy. pro familia wants to raise awareness of this with a public petition to parliament and is calling for a change in legislation.  “We need a lasting nationwide solution for people who cannot meet the cost of con- traception from their own means. After all, each individual has the right – regardless of their social status – to choose the method of contraception that does not present a risk to their health and provides the greatest possible reliability,” says Prof. Daphne Hahn, President of pro familia federal branch.  In the current situation, the choice of contraception is no longer determined by health and personal reasons but by financial reasons. Where you live is decisive, since there are projects in individual local authorities for covering costs, although these are most- ly short-term. And there are no legal grounds for claiming for costs to be covered.  Up until 2004, German social legislation included what was known as “Family Plan- ning Assistance”, through which the social welfare authority covered the cost of con- traceptives prescribed by a doctor. As a result of Hartz IV legislation, this option no longer exists. Now, women and men who receive Unemployment Benefit II (subsis- tence allowance) or Basic Security (for jobseekers) get by on an allowance of €17 said to be for “health care”. All spending on health, such as headache tablets, hay fever treatment and even the pill, needs comes under this item.  “It is often argued that even women on UB II are able to pay for the cheapest pill. Re- gardless of the fact that the cost of contraception was not taken in to account when the standard rate was laid down, this invalidates freedom of choice with respect to contraceptives. Added to that is the fact that many women are unable to take the pill,” says Hahn.  A monthly pack of pills costs between €4.50 and €22, while a vaginal ring costs bet- ween €16 and €22 per month. Coils and implants provide reliable contraception for several years and are more cost-effective in the long term. Hartz IV unemployment benefit claimants cannot afford the one-off cost of €300-400 from the standard rate, nor are regular savings possible.  “It is a subject that comes up frequently in counselling sessions – that there’s not enough money for contraceptives. We are therefore calling on politicians to introduce a bill to cover costs. Ultimately, Germany too is committed to the Programme of Ac- tion adopted at the Cairo International Conference on Population and Development. This expressly states that all women and men have the right to unrestricted access to the safest and most effective, acceptable and affordable methods of family planning.” pro familia has submitted a petition to the German parliament [Bundestag] which is available to sign online until 1st April. The link to sign to petition, latest information and factsheets on the subject are available on the campaign webpage [in German].  www.profamilia.de/pro-familia/kampagne-kostenfreie-verhuetungsmittel.html March 10, 2015

Marine and her husband struggled to afford abortion care
08 March 2019

Affordability, stigma and discrimination major hurdles to abortion care

High costs a major barrier, especially for women in vulnerable situations The cost of abortion can be a major challenge for women in Georgia. “Abortion is quite expensive – between 100 (EUR 33) and 500 lari (EUR 163). The average income in Georgia is 600 - 800 (EUR 196 - 262) lari, so it’s a big chunk of a monthly salary. Some people can’t afford it. Abortion is not covered by the national health care system, not even for socially vulnerable people,” says Ana Iluridze, Head of the Gender Equality Department at the Public Defender's Office of Georgia. Abortion is supposed to be available free of charge to survivors of sexual assault, but bureaucratic measures mean that in reality most aren’t able to access this. Disturbingly, those at the very top of power in women’s sexual and reproductive health do not seem to be aware that affordability is a barrier. When questioned about the cost of abortion care, Georgia’s Deputy Minister of Health Maia Lagvilava appeared to think it was financially accessible to most women: “The services are available… and the population has private insurance as well. The services are offered,” she said, adding the caveat that she wasn’t actually sure if abortion was covered under private insurance in the country. Stigma and discrimination prevent free and safe reproductive lives Stigma and discrimination against women’s reproductive freedom is high in the country, especially for those seeking abortion care. Women are forced to travel great distances, sometimes at crippling expense, to try to keep an abortion secret from their community. One of the major issues is that "women’s sexual and reproductive health is taboo in Georgia,” explains Nino Shurgaia, a youth leader with IPPF member HERA XXI in the city of Senaki. When trying to research access to abortion care in the region she found time and time again that families were not willing to discuss the matter, and many feared what their community would think: “They are afraid that their neighbours or family will find out that they had an abortion. They were worried the information they share with me would be leaked,” she says, adding that often during private interviews she set up as part of the research, a mother-in-law or husband would interrupt and start asking what they were talking about. Indeed, community pressure and social stigma mean that women struggle to live free and safe reproductive lives. One woman described feeling as though ending a pregnancy was her only option because “I was worried what people would think… It wasn’t a problem for me to have a child out of wedlock, but it would have been a problem in my community.” Read the next blog in our series on obstacles to abortion care and women's reproductive freedom in Georgia. Main photo: Marine is from a small village in southwestern Georgia, near the city of Akhaltsikhe. Affordability was a major challenge when she and her husband needed to access abortion care: “We were still young and my husband’s income wasn’t high. We couldn’t cover the cost of abortion with our salaries.” Credit: Jon Spaull/IPPF EN

Because of high costs, some women like Natela go years between visiting the doctor
08 March 2019

A plethora of barriers to women’s reproductive freedom

Women in Georgia face many challenges in accessing sexual and reproductive health care.   For starters, many live in rural communities where job opportunities are limited and poverty is high. Here, access to healthcare is complicated because clinics are few and far between. Public transport is scarce and, when available, expensive. Some women, like Natela, a woman living in a rural area near Signagi, a tiny town in the eastern region of Georgia, go years between visiting the doctor, and when they do it is only for emergency treatment. “It’s been 10 years since I last went to the doctors… it’s terribly expensive so now I don’t go,” she says. Natela visited the doctor for abortion care 10 years ago because, without access to contraception, she faced an unintended pregnancy and could not afford to have another child. The government neglects to provide young people with sexuality education in school, and many people have been denied information about family planning. 45 year-old Tamar (not her real name), a woman living in southwest Georgia, says that before her first abortion, “I couldn’t even recognise a condom, it was something very alien.” Contraceptive care is rarely accessible for people living in remote regions, and it is not free: many women simply cannot afford it. Irina Pshenichnaia, a gynaecologist working at a partner clinic of IPPF member HERA XXI in Senaki, a town in western Georgia, says that even when women manage to access contraception, the state’s failure to ensure education and information mean that they don’t always know how to use it correctly: “One woman was taking the pill three times a day because her friend told her to,” she says. Read the next blog in our series on obstacles to abortion care and women's reproductive freedom in Georgia. Photo credit: Jon Spaull/IPPF EN  

countdown logo
12 February 2018

Countdown 2030 Europe

IPPF European Network is the lead partner of C2030E, a consortium of 15 NGOs working to ensure the advancement of human rights and investment in family planning in the Global South. In European countries and within the EU institutions, Countdown 2030 Europe holds donors to account for their policy and funding commitments to achieving universal access to sexual and reproductive health. www.countdown2030europe.org   

countdown logo
12 February 2018

Countdown 2030 Europe

IPPF European Network is the lead partner of C2030E, a consortium of 15 NGOs working to ensure the advancement of human rights and investment in family planning in the Global South. In European countries and within the EU institutions, Countdown 2030 Europe holds donors to account for their policy and funding commitments to achieving universal access to sexual and reproductive health. www.countdown2030europe.org   

18 February 2014

Pro choice victory in Switzerland

Last week in Switzerland a clear majority of voters (69.8%) rejected a conservative initiative that aimed at limiting equal access to abortion.  The proposed initiative would have excluded abortions from the healthcare reimbursement plan, making greater barriers to women and girls, especially women with limited economic means. All women should have access to reproductive health care, including pregnancy terminations, regardless of their economic status. However, discriminative restrictions on reimbursement plans make abortion services an unavailable choice for many low-income women, creating further inequality. Last week’s pro choice victory reaffirms the vote of 2002, when the overwhelming majority of Swiss voters supported a change in the legislation. This granted women abortion on request within the first 12 weeks of pregnancy and later in pregnancy for medical reasons. By rejecting the conservative initiative, Swiss voters have shown that they will not accept any backward steps when it comes to women’s rights and reproductive health.

aaron-burden-xG8IQMqMITM-unsplash_2.jpg
30 November 2017

Photo Gallery: Rising HIV numbers and funding cutbacks - Macedonia at the crossroads

This article was written in September 2017. Since then, thanks to the work of NGOs including our member HERA, Macedonia’s government has committed to providing long-term funding for all HIV programmes for marginalised people. Although HIV prevalence is low in Macedonia, with only 151 people registered as living with HIV, these small numbers mask a complex picture, and one that is rapidly changing. In 2016, there were 40 new HIV diagnoses, the majority of them among men who have sex with men.  Macedonia is not alone in facing a rise in HIV cases. In many parts of Central and Eastern Europe, the rate of new infections is growing. Between 2010 and 2015, the region saw a 50 per cent rise in new HIV infections annually. Another looming problem that threatens to send Macedonian HIV rates spiralling upwards is a funding crisis precipitated by donor cutbacks and political uncertainty. Between 2004 and 2016, Macedonian HIV programmes received almost $25 million from the Global Fund to Fight AIDS, Tuberculosis and Malaria. Much of this money was channelled into HIV prevention, funding NGOs that target those deemed most vulnerable to infection – sex workers, people who inject drugs, men who have sex with men and prisoners. But in 2016 this funding was phased out and NGOs on the frontline are left hoping that the new government will deliver fully on a recent commitment to step in with similar levels of funding in 2018. In the chasm left by the country’s public healthcare system, Macedonia’s sexual health and rights NGOs work tirelessly to plug the gap, often on a shoestring and in an increasingly uncertain funding landscape. HERA, IPPF's member in Macedonia, is a leading NGO providing free HIV testing services, sexual health support and advocacy. It works closely with smaller organisations around the country to ensure support for young people, sex workers, people who inject drugs and men who have sex with men. These NGOs are many people’s first port of call for HIV tests and other vital health care.  

Strengthening the Right to Access to Contraceptives Choice for People with Low Income. Pro familia launches petition to be presented to the German parliament.
12 March 2015

Strengthening the Right to Access to Contraceptives Choice for People with Low Income

Pro familia launches petition to be presented to the German parliament If you do not have much money in Germany, there are a lot of things you have to go without. When that includes contraceptives, it can be disastrous. Studies show that women change their contraceptive behaviour when they are in financial need: they switch to cheaper and less reliable forms of contraception or use no contraception at all, thus risking an unwanted pregnancy. pro familia wants to raise awareness of this with a public petition to parliament and is calling for a change in legislation.  “We need a lasting nationwide solution for people who cannot meet the cost of con- traception from their own means. After all, each individual has the right – regardless of their social status – to choose the method of contraception that does not present a risk to their health and provides the greatest possible reliability,” says Prof. Daphne Hahn, President of pro familia federal branch.  In the current situation, the choice of contraception is no longer determined by health and personal reasons but by financial reasons. Where you live is decisive, since there are projects in individual local authorities for covering costs, although these are most- ly short-term. And there are no legal grounds for claiming for costs to be covered.  Up until 2004, German social legislation included what was known as “Family Plan- ning Assistance”, through which the social welfare authority covered the cost of con- traceptives prescribed by a doctor. As a result of Hartz IV legislation, this option no longer exists. Now, women and men who receive Unemployment Benefit II (subsis- tence allowance) or Basic Security (for jobseekers) get by on an allowance of €17 said to be for “health care”. All spending on health, such as headache tablets, hay fever treatment and even the pill, needs comes under this item.  “It is often argued that even women on UB II are able to pay for the cheapest pill. Re- gardless of the fact that the cost of contraception was not taken in to account when the standard rate was laid down, this invalidates freedom of choice with respect to contraceptives. Added to that is the fact that many women are unable to take the pill,” says Hahn.  A monthly pack of pills costs between €4.50 and €22, while a vaginal ring costs bet- ween €16 and €22 per month. Coils and implants provide reliable contraception for several years and are more cost-effective in the long term. Hartz IV unemployment benefit claimants cannot afford the one-off cost of €300-400 from the standard rate, nor are regular savings possible.  “It is a subject that comes up frequently in counselling sessions – that there’s not enough money for contraceptives. We are therefore calling on politicians to introduce a bill to cover costs. Ultimately, Germany too is committed to the Programme of Ac- tion adopted at the Cairo International Conference on Population and Development. This expressly states that all women and men have the right to unrestricted access to the safest and most effective, acceptable and affordable methods of family planning.” pro familia has submitted a petition to the German parliament [Bundestag] which is available to sign online until 1st April. The link to sign to petition, latest information and factsheets on the subject are available on the campaign webpage [in German].  www.profamilia.de/pro-familia/kampagne-kostenfreie-verhuetungsmittel.html March 10, 2015