Fertility Regulation in Kazakhstan : The Role of Providers and the Public Financial Cost
This study examines fertility regulation in Kazakhstan, with dual emphases on providers' attitudes toward abortion and the public financial costs of abortion provision. Though abortion incidence declined sharply in the 1990s in Eastern Europea...
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| Format: | Working Paper |
| Language: | English en_US |
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World Bank, Washington, DC
2013
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| Subjects: | |
| Online Access: | http://documents.worldbank.org/curated/en/2006/11/7405560/fertility-regulation-kazakhstan-role-providers-public-financial-cost http://hdl.handle.net/10986/13650 |
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okr-10986-13650 |
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| recordtype |
oai_dc |
| repository_type |
Digital Repository |
| institution_category |
Foreign Institution |
| institution |
Digital Repositories |
| building |
World Bank Open Knowledge Repository |
| collection |
World Bank |
| language |
English en_US |
| topic |
ABORTION ABORTION COMPLICATIONS ABORTION RATE ABORTION RATES ABORTION SERVICES AFTER ABORTION ANALGESICS ANESTHESIA ANTIBIOTICS BLOOD PRODUCTS CHILD-BEARING CHILDREN PER WOMAN CLINICS CONCEPTION CONDOM CONDOMS CONTRACEPTION CONTRACEPTION USE CONTRACEPTIVE CHOICE CONTRACEPTIVE CHOICES CONTRACEPTIVE METHOD CONTRACEPTIVE METHODS CONTRACEPTIVE PREVALENCE CONTRACEPTIVE PREVALENCE RATES CONTRACEPTIVE SERVICES CONTRACEPTIVE SUPPLIES CONTRACEPTIVE USE CONTRACEPTIVES DECLINE IN FERTILITY DECLINES IN FERTILITY DEVELOPING COUNTRIES DRUGS ECTOPIC PREGNANCY EFFECTIVE CONTRACEPTIVE EFFECTIVE FAMILY PLANNING EMERGENCY FACILITIES FAMILY PLANNING FAMILY PLANNING METHODS FAMILY PLANNING PROGRAM FAMILY PLANNING SERVICES FAMILY SIZE FEMALE STERILIZATION FERTILITY FERTILITY CONTROL FERTILITY LEVELS FERTILITY RATE FERTILITY RATES FERTILITY REGULATION GROSS NATIONAL INCOME GYNECOLOGIST GYNECOLOGISTS GYNECOLOGY HEALTH HEALTH CARE HEALTH CARE SYSTEMS HEALTH FACILITIES HEALTH FACILITY HEALTH INTERVENTIONS HEALTH PROBLEMS HEALTH PROVIDERS HOSPITAL HUMAN DEVELOPMENT HYPERTENSION INDUCED ABORTION INTERVENTION ISSUE OF ABORTION IUD IUDS LACK OF INFORMATION LOWER FERTILITY MATERNAL DEATHS MATERNAL MORTALITY MEDICAL FACILITIES MEDICAL PERSONNEL MIDWIFE MIDWIVES MINISTRY OF HEALTH MODERN CONTRACEPTIVE METHODS MODERN CONTRACEPTIVES MODERN METHODS OF CONTRACEPTION MORBIDITY NATIONAL HEALTH NATIONAL LEVEL NUMBER OF ABORTIONS NUMBER OF BIRTHS NUMBER OF WOMEN NURSE NURSES NUTRITION ORAL CONTRACEPTIVE ORAL CONTRACEPTIVES PATIENTS PERIODIC ABSTINENCE PHYSICIANS PILL PILLS POLICY MAKERS POPULATION DIVISION POPULATION POLICY POPULATION POLICY DATA POST-ABORTION POST-ABORTION CONTRACEPTIVE POST-ABORTION COUNSELING POSTABORTION PREVENTION OF INFECTION PRIMARY HEALTH CARE PRIMARY HEALTH CARE FACILITIES PROVISION OF SERVICES PUBLIC HEALTH RELIANCE ON ABORTION REPRODUCTION REPRODUCTIVE HEALTH RURAL DISTRICT SERVICE PROVIDERS SOCIAL AFFAIRS SPERMICIDES STATE POLICIES TERTIARY LEVEL TOTAL FERTILITY RATE TREATMENT OF COMPLICATIONS UNFPA UNITED NATIONS POPULATION FUND UNMARRIED YOUNG MEN UNWANTED PREGNANCY URBAN AREAS USE OF FAMILY PLANNING USE OF FAMILY PLANNING METHODS VICIOUS CYCLE WASTE WOMAN WOMEN OF CHILD-BEARING AGE YOUNG MEN |
| spellingShingle |
ABORTION ABORTION COMPLICATIONS ABORTION RATE ABORTION RATES ABORTION SERVICES AFTER ABORTION ANALGESICS ANESTHESIA ANTIBIOTICS BLOOD PRODUCTS CHILD-BEARING CHILDREN PER WOMAN CLINICS CONCEPTION CONDOM CONDOMS CONTRACEPTION CONTRACEPTION USE CONTRACEPTIVE CHOICE CONTRACEPTIVE CHOICES CONTRACEPTIVE METHOD CONTRACEPTIVE METHODS CONTRACEPTIVE PREVALENCE CONTRACEPTIVE PREVALENCE RATES CONTRACEPTIVE SERVICES CONTRACEPTIVE SUPPLIES CONTRACEPTIVE USE CONTRACEPTIVES DECLINE IN FERTILITY DECLINES IN FERTILITY DEVELOPING COUNTRIES DRUGS ECTOPIC PREGNANCY EFFECTIVE CONTRACEPTIVE EFFECTIVE FAMILY PLANNING EMERGENCY FACILITIES FAMILY PLANNING FAMILY PLANNING METHODS FAMILY PLANNING PROGRAM FAMILY PLANNING SERVICES FAMILY SIZE FEMALE STERILIZATION FERTILITY FERTILITY CONTROL FERTILITY LEVELS FERTILITY RATE FERTILITY RATES FERTILITY REGULATION GROSS NATIONAL INCOME GYNECOLOGIST GYNECOLOGISTS GYNECOLOGY HEALTH HEALTH CARE HEALTH CARE SYSTEMS HEALTH FACILITIES HEALTH FACILITY HEALTH INTERVENTIONS HEALTH PROBLEMS HEALTH PROVIDERS HOSPITAL HUMAN DEVELOPMENT HYPERTENSION INDUCED ABORTION INTERVENTION ISSUE OF ABORTION IUD IUDS LACK OF INFORMATION LOWER FERTILITY MATERNAL DEATHS MATERNAL MORTALITY MEDICAL FACILITIES MEDICAL PERSONNEL MIDWIFE MIDWIVES MINISTRY OF HEALTH MODERN CONTRACEPTIVE METHODS MODERN CONTRACEPTIVES MODERN METHODS OF CONTRACEPTION MORBIDITY NATIONAL HEALTH NATIONAL LEVEL NUMBER OF ABORTIONS NUMBER OF BIRTHS NUMBER OF WOMEN NURSE NURSES NUTRITION ORAL CONTRACEPTIVE ORAL CONTRACEPTIVES PATIENTS PERIODIC ABSTINENCE PHYSICIANS PILL PILLS POLICY MAKERS POPULATION DIVISION POPULATION POLICY POPULATION POLICY DATA POST-ABORTION POST-ABORTION CONTRACEPTIVE POST-ABORTION COUNSELING POSTABORTION PREVENTION OF INFECTION PRIMARY HEALTH CARE PRIMARY HEALTH CARE FACILITIES PROVISION OF SERVICES PUBLIC HEALTH RELIANCE ON ABORTION REPRODUCTION REPRODUCTIVE HEALTH RURAL DISTRICT SERVICE PROVIDERS SOCIAL AFFAIRS SPERMICIDES STATE POLICIES TERTIARY LEVEL TOTAL FERTILITY RATE TREATMENT OF COMPLICATIONS UNFPA UNITED NATIONS POPULATION FUND UNMARRIED YOUNG MEN UNWANTED PREGNANCY URBAN AREAS USE OF FAMILY PLANNING USE OF FAMILY PLANNING METHODS VICIOUS CYCLE WASTE WOMAN WOMEN OF CHILD-BEARING AGE YOUNG MEN Rani, Manju Chao, Shiyan Arystanova, Gulzada Rakhimova, Meruert Fertility Regulation in Kazakhstan : The Role of Providers and the Public Financial Cost |
| geographic_facet |
Kazakhstan |
| relation |
HNP discussion paper series; |
| description |
This study examines fertility regulation
in Kazakhstan, with dual emphases on providers'
attitudes toward abortion and the public financial costs of
abortion provision. Though abortion incidence declined
sharply in the 1990s in Eastern European countries and in
the former Soviet republics, it stagnated at relatively high
levels in the early 2000s, accounting for a substantial
proportion of gynecological morbidity and maternal
mortality. Limited literature is available on the role of
health service providers' attitudes that may encourage
or discourage abortion culture. Additionally, most studies
examine abortion incidence from the perspective of its
impact on women's health, while the issue of the public
financial burden imposed by the provision of services for
"avoidable" abortions remains unexplored. This
study sheds lights on these two areas by conducting a
two-part field survey in Kazakhstan. Three-stage stratified
sampling was used to select 126 providers from 52 health
facilities from four oblasts and two major cities (Almaty
and Astana) at different administrative levels to assess
providers' attitudes and perceptions; and to analyze
the public costs of providing abortion and family planning
services. Findings from the provider survey suggest that
providers' biases towards certain contraceptive
methods-partly attributable to their lack of training in
alternative methods-lead them to limit the choice of
contraceptive methods on offer, thereby reducing the quality
of family planning services and potentially contributing to
stagnating abortion rates. Findings from the costing survey
suggest that in terms of cost per birth averted,
contraceptives are almost 3.2 times more cost-effective than
abortion services. In 2004, abortion services accounted for
almost one percent of total public health spending. The
study suggests that by expanding family planning services,
including increasing contraceptive choices, the reliance on
abortion for fertility control may be reduced. Savings may
be redirected to improved family planning services or other
public health interventions. |
| format |
Publications & Research :: Working Paper |
| author |
Rani, Manju Chao, Shiyan Arystanova, Gulzada Rakhimova, Meruert |
| author_facet |
Rani, Manju Chao, Shiyan Arystanova, Gulzada Rakhimova, Meruert |
| author_sort |
Rani, Manju |
| title |
Fertility Regulation in Kazakhstan : The Role of Providers and the Public Financial Cost |
| title_short |
Fertility Regulation in Kazakhstan : The Role of Providers and the Public Financial Cost |
| title_full |
Fertility Regulation in Kazakhstan : The Role of Providers and the Public Financial Cost |
| title_fullStr |
Fertility Regulation in Kazakhstan : The Role of Providers and the Public Financial Cost |
| title_full_unstemmed |
Fertility Regulation in Kazakhstan : The Role of Providers and the Public Financial Cost |
| title_sort |
fertility regulation in kazakhstan : the role of providers and the public financial cost |
| publisher |
World Bank, Washington, DC |
| publishDate |
2013 |
| url |
http://documents.worldbank.org/curated/en/2006/11/7405560/fertility-regulation-kazakhstan-role-providers-public-financial-cost http://hdl.handle.net/10986/13650 |
| _version_ |
1764423975135346688 |
| spelling |
okr-10986-136502021-04-23T14:03:09Z Fertility Regulation in Kazakhstan : The Role of Providers and the Public Financial Cost Rani, Manju Chao, Shiyan Arystanova, Gulzada Rakhimova, Meruert ABORTION ABORTION COMPLICATIONS ABORTION RATE ABORTION RATES ABORTION SERVICES AFTER ABORTION ANALGESICS ANESTHESIA ANTIBIOTICS BLOOD PRODUCTS CHILD-BEARING CHILDREN PER WOMAN CLINICS CONCEPTION CONDOM CONDOMS CONTRACEPTION CONTRACEPTION USE CONTRACEPTIVE CHOICE CONTRACEPTIVE CHOICES CONTRACEPTIVE METHOD CONTRACEPTIVE METHODS CONTRACEPTIVE PREVALENCE CONTRACEPTIVE PREVALENCE RATES CONTRACEPTIVE SERVICES CONTRACEPTIVE SUPPLIES CONTRACEPTIVE USE CONTRACEPTIVES DECLINE IN FERTILITY DECLINES IN FERTILITY DEVELOPING COUNTRIES DRUGS ECTOPIC PREGNANCY EFFECTIVE CONTRACEPTIVE EFFECTIVE FAMILY PLANNING EMERGENCY FACILITIES FAMILY PLANNING FAMILY PLANNING METHODS FAMILY PLANNING PROGRAM FAMILY PLANNING SERVICES FAMILY SIZE FEMALE STERILIZATION FERTILITY FERTILITY CONTROL FERTILITY LEVELS FERTILITY RATE FERTILITY RATES FERTILITY REGULATION GROSS NATIONAL INCOME GYNECOLOGIST GYNECOLOGISTS GYNECOLOGY HEALTH HEALTH CARE HEALTH CARE SYSTEMS HEALTH FACILITIES HEALTH FACILITY HEALTH INTERVENTIONS HEALTH PROBLEMS HEALTH PROVIDERS HOSPITAL HUMAN DEVELOPMENT HYPERTENSION INDUCED ABORTION INTERVENTION ISSUE OF ABORTION IUD IUDS LACK OF INFORMATION LOWER FERTILITY MATERNAL DEATHS MATERNAL MORTALITY MEDICAL FACILITIES MEDICAL PERSONNEL MIDWIFE MIDWIVES MINISTRY OF HEALTH MODERN CONTRACEPTIVE METHODS MODERN CONTRACEPTIVES MODERN METHODS OF CONTRACEPTION MORBIDITY NATIONAL HEALTH NATIONAL LEVEL NUMBER OF ABORTIONS NUMBER OF BIRTHS NUMBER OF WOMEN NURSE NURSES NUTRITION ORAL CONTRACEPTIVE ORAL CONTRACEPTIVES PATIENTS PERIODIC ABSTINENCE PHYSICIANS PILL PILLS POLICY MAKERS POPULATION DIVISION POPULATION POLICY POPULATION POLICY DATA POST-ABORTION POST-ABORTION CONTRACEPTIVE POST-ABORTION COUNSELING POSTABORTION PREVENTION OF INFECTION PRIMARY HEALTH CARE PRIMARY HEALTH CARE FACILITIES PROVISION OF SERVICES PUBLIC HEALTH RELIANCE ON ABORTION REPRODUCTION REPRODUCTIVE HEALTH RURAL DISTRICT SERVICE PROVIDERS SOCIAL AFFAIRS SPERMICIDES STATE POLICIES TERTIARY LEVEL TOTAL FERTILITY RATE TREATMENT OF COMPLICATIONS UNFPA UNITED NATIONS POPULATION FUND UNMARRIED YOUNG MEN UNWANTED PREGNANCY URBAN AREAS USE OF FAMILY PLANNING USE OF FAMILY PLANNING METHODS VICIOUS CYCLE WASTE WOMAN WOMEN OF CHILD-BEARING AGE YOUNG MEN This study examines fertility regulation in Kazakhstan, with dual emphases on providers' attitudes toward abortion and the public financial costs of abortion provision. Though abortion incidence declined sharply in the 1990s in Eastern European countries and in the former Soviet republics, it stagnated at relatively high levels in the early 2000s, accounting for a substantial proportion of gynecological morbidity and maternal mortality. Limited literature is available on the role of health service providers' attitudes that may encourage or discourage abortion culture. Additionally, most studies examine abortion incidence from the perspective of its impact on women's health, while the issue of the public financial burden imposed by the provision of services for "avoidable" abortions remains unexplored. This study sheds lights on these two areas by conducting a two-part field survey in Kazakhstan. Three-stage stratified sampling was used to select 126 providers from 52 health facilities from four oblasts and two major cities (Almaty and Astana) at different administrative levels to assess providers' attitudes and perceptions; and to analyze the public costs of providing abortion and family planning services. Findings from the provider survey suggest that providers' biases towards certain contraceptive methods-partly attributable to their lack of training in alternative methods-lead them to limit the choice of contraceptive methods on offer, thereby reducing the quality of family planning services and potentially contributing to stagnating abortion rates. Findings from the costing survey suggest that in terms of cost per birth averted, contraceptives are almost 3.2 times more cost-effective than abortion services. In 2004, abortion services accounted for almost one percent of total public health spending. The study suggests that by expanding family planning services, including increasing contraceptive choices, the reliance on abortion for fertility control may be reduced. Savings may be redirected to improved family planning services or other public health interventions. 2013-05-29T18:56:09Z 2013-05-29T18:56:09Z 2006-11 http://documents.worldbank.org/curated/en/2006/11/7405560/fertility-regulation-kazakhstan-role-providers-public-financial-cost http://hdl.handle.net/10986/13650 English en_US HNP discussion paper series; CC BY 3.0 IGO http://creativecommons.org/licenses/by/3.0/igo/ World Bank World Bank, Washington, DC Publications & Research :: Working Paper Publications & Research Kazakhstan |