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Each human being has the right to reproductive health, which makes possible having healthy children, an intimate relationship and a happy family. UNFPA’s activity in the field of reproductive health is to ensure that every pregnancy is wanted, every birth is safe, every young person is free of HIV and AIDS, and every girl and woman is treated with dignity and respect.

The barriers to obtaining information or services needed by young people give rise to another important aspect of UNFPA activity – young people’s reproductive health.

The special importance of reproductive health for country development has been recognized at the highest level. At the World Summit 2005 universal access to reproductive health services was included into the list of Millennium Development Goals. UNFPA works to achieve this goal across the globe by 2015.

Safe Motherhood

Lately there has been a tendency toward the deterioration of women’s reproductive health in Belarus. During the period from 2005 to 2010 the number of women with contagious diseases increased by 1.2 times, the number of women with urinary tract infections, impaired lipid metabolism and venous complications – by 1.3 times; with diabetes – by 2.1 times. The increased disease incidence is reflected in the number of easy deliveries, which make one third of all childbirths.

Another negative factor affecting women’s reproductive health is abortions. However, it is noteworthy that within the last few years there has been a 4-fold decrease of the number of abortions in the republic. For the period from 1990 – 2010 the number of abortions in Belarus decreased from 260.8 thousand to 33.3 thousand, and from 2002 the number of childbirths for the first time exceeded the number of abortions. However, still every seventh abortion is performed in women with the first pregnancy, every twelfth – in adolescents and young people under 20.

In spite of the above the Republic of Belarus is one of the countries with a low infant and child mortality rate. As regards this indicator Belarus stands on a level with the developed countries of the world.

Family Planning

To ensure access of women to family planning services, information and counseling rooms for reproductive health and family planning were opened at antenatal clinics in the Republic of Belarus. Besides, there are health schools for future mothers at antenatal clinics and healthy child rooms at child health centres. To provide counseling and medical assistance to adolescent girls paediatric and adolescent gynaecology offices were opened at antenatal clinics.

About each fifth couple in Belarus faces infertility, and male infertility accounts for 50% of infertile couples. Therefore, an essential area of work to preserve and improve the population’s reproductive health is the development and practical implementation of effective medical diagnostic methods, early detection, treatment and rehabilitation of impaired reproductive functions, measures to prevent unwanted pregnancies and abortions, treatment of infertility in women and men.

HIV AIDS Prevention

As of May1, 2012 there were 13,415 cases of HIV infection registered in Belarus (incidence rate was 111.9 per 100,000 people). For the four months of 2012 four hundred and sixty HIV-infected people were registered (for four months of 2011 – there were 374 new cases). The growth rate is 23.0%. The incidence rate is 4.9 per 100,000 persons (for four months of 2011 – the rate was 3.9). Generally in the republic women account for 39.4% (5283 persons), and men for 60.6% (8132 persons) of all HIV patients.

The overwhelming majority of HIV patients are young people from 15 to 29. The total incidence of HIV infection in this age group is 8,118 cases (share in the total number of HIV patients is 60.5%).

According to the data of long-term observations there is a tendency toward the growth of HIV incidence rate in the republic every year from 7.5 per 100,000 persons in 2006 to 111.9 per 100,000 in 2012.

In 2008 - 2009 the sexual route of transmission accounted for 75 – 77.6% of new HIV cases. The sexual route is the leading route of transmission both among men and women. Since 1998 the share of men infected during sex in the total amount of annually registered HIV cases in men has grown by 4 times (from 15.9% to 64.6%), and the corresponding share of women has grown almost by 3 times (from 32.9% to 90.2%). In 2009 ninety point two per cent of new HIV cases among women and 64.6% of new HIV cases among men were due to unprotected sex.

Adolescent Reproductive Health

Smoking, alcoholism, drug addiction, casual sex, STIs and HIV constitute major risk factors to adolescents’ and young people’s health.

According to the 2011 data 8,952 drug addicts and 4,458 persons taking drugs occasionally were under supervision of the substance abuse centres. According to the estimates of the experts the actual number of drug users might reach 75-80 thousand people. And with that the number of drug users has been growing every year. For instance, in 2002 there were 5,833 drug addicts and in 2006 - 6,427 drug addicts registered with substance abuse treatment centres.

Drug abuse has also grown younger. In 2011 the share of registered patients under 15 was 2.9%, 15-19 years - 10.3%, 20-24 years – 22.4%, and 25-34 years – 48.9%.

High incidence of sexually transmitted infections (STIs) is still an urgent problem in the republic: if in 2004 there were 1,466 cases for 100,000 persons, in 2006 the ratio was 1,729 per 100,000 persons – demonstrating a 1.9% increase. However, there is a reduction of STIs incidence due to such infections as syphilis, gonorrhea, trichomoniasis, and an increase due to bacterial vaginosis, chlamydiosis, mycoplasmosis and candidiasis. In 2006 the incidence of urinary tract chlamydiosis increased almost by 2 times as compared to 2000 and amounted to 219.0 cases per 100,000 persons; within the same period the incidence of bacterial vaginosis increased from 124.0 to 317.0 cases per 100,000 persons.

According to the research performed as part of the Global Fund project in 2007 (1500 young men and women aged 15-24 were surveyed) 63.3% of the respondents had already engaged in sexual intercourse. The share of people who used condoms during the first sexual intercourse was 58.5% (2006 – 52.8%). With that the main motive to refuse using a condom according to 62.9% of respondents was confidence in their partner, 17.3% - undermined sexual pleasure, and 19.3% - no possibility of buying one.

In various cities and towns of Belarus Youth Health Centres were opened and they operate now. The Centres provide qualified medical and psychological assistance to adolescents on reproductive health matters: methods of preventing unwanted pregnancies, sexually transmitted infections, HIV infection; the Centres also advocate for healthy lifestyles and responsible young people’s behaviour as regards their reproductive health. Gynaecologists, psychologists, urologists and andrologists who received special training organized by UNFPA and the Ministry of Health of the Republic of Belarus work in these Centres. Counseling adolescents and youth, and medical examination at such Centres is free of charge, the services are provided with benevolence and confidentiality.