"For a healthy mother, healthy child, healthy nation--plan your family!" This message, which appears in the booklet containing this illustration and all the IEC materials, underscores the idea that family planning is in line with Kyrgyzstan's cultural traditions.

Having a large family has been a strong cultural tradition in Kyrgyzstan. Often, though, children within a family are born soon after one another, causing serious health problems and sometimes death for the mothers and newborns.

After the country gained independence in 1991, the government introduced a program to reduce maternal and infant mortality by increasing the use of family planning. The program has already met with some success: though the data on mortality rates are inconclusive at this time, between 1991 and 1996 contraceptive use among women of reproductive age increased from almost 22% to almost 33%.

But while the use of contraceptives has increased, the range of methods used remains limited to abortion and the IUD. Other methods constitute only a small percentage of the contraceptives used, and use of "modern" methods, such as oral contraceptive pills, is concentrated mainly in Bishkek, the capital.

The continued reliance on abortion and the IUD as family planning methods has been attributed to a lack of information, on the part of both service providers and the public, about the range of methods available. AVSC is involved in several efforts to address this need for more information. In one project, AVSC has been working with local organizations in Kyrgyzstan to develop client information, education, and communication (IEC) materials for use in the country.

Need for Materials

Before the breakup of the Soviet Union, the IEC materials used in Kyrgyzstan came primarily from the Public Health Education Center in Moscow. They tended to focus on general health issues, providing little or no information about family planning.

Now, even these materials are unavailable in Kyrgyzstan, and the need for them is urgent. An assessment of reproductive health services conducted late last year by AVSC and local researchers in Kyrgyzstan revealed that most clinics, especially those in rural regions, do not have any IEC materials to give their clients. The study also found that when materials were available, they were either too technical or too detailed for clients or they were in Russian, which some clients cannot read.

Giving Access to All

With funding from the United Nations Population Fund (UNFPA), AVSC is collaborating with the Kyrgyzstan Ministry of Health and the Republican Health Education Center (HEC) on an IEC campaign. The program aims to educate the public about contraception in order to increase birth spacing and prevent unintended pregnancies.

The HEC, with assistance from AVSC, is producing print materials and TV and radio programs on issues related to reproductive health. So far, five colorful booklets and a pocket calendar with condom instructions have been published. Three TV programs and 10 radio spots are currently in production.

All the materials are being produced in Kyrgyz, Russian, and Uzbek, the languages spoken by the country's three main ethnic groups. In addition, as the materials are developed, they are tested with women and men living in both urban and rural areas to ensure their usefulness, given the differing needs and values of these populations.

The campaign is being launched this fall, and it is still too early to determine public reaction to the materials. However, it is hoped that this program will help improve the health and well-being of the people of Kyrgyzstan.

Daria Teutonico manages AVSC's programs in Central Asia.