Uzbekistan Case Study Report RC2012

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					                  UZBEKISTAN
CASE STUDY REPORT TO IPPF EN REGIONAL COUNCIL 2012

1) Political Environment

Since independence, Uzbekistan has consistently been implementing a strategy for large-scale
constructive socio-political and socio-economic transformations aimed at achieving: peace in
the country, prosperity in the homeland, well-being of the people.

The socially oriented market economy, state and public construction system of independent
Uzbekistan are developing dynamically.

Successive implementation of socio-economic reforms, strong social policy has resulted in a
steady growth in real incomes and prosperity of the population. Systems of education and
training, personnel training, health protection, and culture that are unique in substance and
content have been created.

A new generation of people, independently and modernly thinking personnel of new
formation who are brought up on national and panhuman values and able to really implement
large-scale tasks for modernization of the country and construction of modern democratic
society, people with a deep sense of their responsibility for the present and future of the
country, responsibility for destiny of their native country are entering into life.

The successive movement of the country on the way of progress and democracy rests on
richest natural resources, which Uzbekistan possesses. Since the first days of independent
development, a course was set for rational use of natural resources, conservation of clean
natural environment for future generations. This is one of the major conditions and factors for
ensuring healthy and spiritually rich life of the population in the country.

For the years of its independent development, the country has acquired a considerable
experience in solving environmental problems and overcoming their negative consequences.
However, the strength and scope of challenges existing in this field require consolidating
efforts of state structures, public associations, civil society institutions, citizens in integrated
solving of environmental situation improvement problems in the country and region. The
protection of healthy environment should become a business of the government, society and
each citizen of the country.

Health Care System and Services

MATERNAL AND CHILD HEALTH

Maternal and child health is a priority and the state policy of Uzbekistan since the early days
of Independence. Even before the signing of the Millennium Declaration government began
to take a number of targeted programs aimed at protecting the health of mothers and children,
"Mother and child screening" (1998), "Healthy Generation" (2000), "Mother and Child"
(2001) "On additional measures to improve the health of women and the younger generation"
(2002), "On Measures to Implement the priority directions of the medical culture in the
family, the strengthening of women's health, birth and raising a healthy generation"
(2005). All of these programs contain measures to create necessary conditions for the safe
birth and raising a healthy child. In addition, the government is implementing programs and


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projects on safe motherhood and improving women's reproductive health, encourage and
promote breastfeeding, prevention and elimination of micronutrient deficiency through food
fortification (flour and salt), vitamin A supplementation in children aged 6-59 months, iron
and folic acid among women of childbearing age.

The risk of infant and child mortality rates is determined by the condition of women's
reproductive health and quality of health services in the perinatal period and during newborn
care. In Uzbekistan, as part of health care reform there has been significant progress in
improving women's health, which has significantly reduced the risk of mortality among
children. However, the improvement of the quality of care in the neonatal period is staying as
important question, since more than 50% of child deaths occur in the first 30 days of life.

During the period from 1991 to 2010 the infant mortality rate has dropped from 35.3 to
10.6 ppm at 1,000.

Medical care for children's population of Uzbekistan is at all levels of the health
system. Thorough medical examination covered 98·9% of children 0-14 years old.

According to the international organization “Save the children” (UK), Uzbekistan is one of
the leaders in terms of favorable conditions for women and protecting motherhood among
125 countries. This is the best indicator in Central Asia and one of the highest in the CIS and
Asia. In 2007, Uzbekistan became one of the four countries of the 53 countries of the region
defined by the WHO for the implementation of the European strategy "Health and
development of children and adolescents." The main criteria for selection were the
government's commitment to raising a healthy generation and the country's readiness to
implement the idea.

As a result of government programs by 2010 the maternal mortality rate decreased by more
than 2 times, infant mortality 3 times compared with 1991. The average life expectancy
during this period increased from 67 to 73 years, and women - up to 75 years.

A strong social policy of Uzbekistan and the implementation of state programs fully
contribute to and ensure achievement of Uzbekistan adopted Millennium Development
Goals.

REPRODUCTIVE HEALTH IN UZBEKISTAN

In 2000 at the Millennium Summit, the Government of the Republic of Uzbekistan as a
member of the United Nations committed itself to achieve the eight Millennium
Development Goals (MDGs).

MDG 4 is to reduce infant mortality. The objective of this goal - to achieve for the period
from 1990 to 2015 reduced mortality among children under age 5 by two thirds. Progress
towards this goal is assessed rates of child and infant mortality rates and an indicator of the
proportion of children under one year vaccinated against measles.

MDG 5 has identified the problem of reducing maternal mortality by three quarters between
1990-2015 and one-third over the period 2001-2015, as well as support by 2015, universal
access to reproductive health services. Progress to achieve MDG 5 is estimated using the rate
of maternal mortality, the proportion of births attended by skilled personnel with the
participation, the proportion of women under the supervision of medical staff in the first 3
months of pregnancy, the number of abortions per 1,000 women.


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MDG 6 is to combat the spread of HIV/AIDS, tuberculosis and malaria. The objective of this
goal is to halt the spread of HIV/AIDS, and begun to reverse incidence by 2015. Indicators of
the progress to achieve objectives are: HIV prevalence among certain vulnerable groups, the
proportion of drug users who have access to harm reduction, HIV prevalence among pregnant
women, HIV prevalence among women and children with access to antiretroviral therapy;
awareness among young people aged 15 -24 years on HIV/AIDS.

National goals and objectives of the MDGs are included in a number of government
policies and programs. Maternal and child health is a priority for health care reform and
elevated to the rank of state policy.

Over the past decade, the Ministry of Health of the Republic of Uzbekistan along with other
ministries, the Women's Committee of Uzbekistan, Charity fund "Mahalla" Youth
organization "Kamolot" and other non-governmental organizations was held to implement the
following State programs and decisions of the President of the Republic of Uzbekistan and
the decisions of the Cabinet of Ministers (DCM):

      DCM No. 140 dated April 1, 1998. "Screening of Mother and Child"
      DCM No. 46 dated February 15, 2000. "Healthy Generation"
      DCM No. 68 dated February 5, 2001. "Mother and Child"
      DCM No. 32 dated 25 February 2002. "On additional measures to improve the health
       of women and the younger generation,"
      DCM No. 242 dated July 5, 2002. "On measures for implementation of priority
       directions of the medical culture in the family, women's health, birth and raising a
       healthy generation"
      DCM No. 515 dated November 2, 2004. "On measures to implement the project
       "Strengthening the health of women and children" with the Asian Development Bank"
      Resolution of the President of the Republic of Uzbekistan No. 153 dated August 11,
       2005. "On Measures to Implement the National Flour Fortification Programme"
      Decree of the President of the Republic of Uzbekistan dated September 19, 2007. No.
       3923 "On main directions of further deepening reforms and implementing the state
       program of health care"
      Resolution of the President of the Republic of Uzbekistan dated October 2, 2007. No.
       700 "On measures to improve the organization of medical institutions of the republic"
      Resolution of the President of the Republic of Uzbekistan No. 892 dated 18 June
       2008. "On the State program of early detection of congenital and hereditary diseases
       to prevent the birth of disabled children."
      Resolution of the President of the Republic of Uzbekistan No. 1096 dated April 13,
       2009. "On additional measures to protect the health of mother and child, a healthy
       generation"
      Resolution of the President of the Republic of Uzbekistan No. 1144 dated July 1,
       2009. "On the Program of measures to further strengthen and improve the efficiency
       of the process to improve reproductive health, birth of a healthy child, the formation
       of physically and spiritually mature generation for 2009-2013."

Since 1998, Uzbekistan began and continued dramatic changes in the health care system
when it created organizational - institutional structure of health care services, including
primary health care with the newly created rural health centers, single tiered emergency
medical care, republican specialized medical centers and regional perinatal centers.

Further reforms of the health care system are defined by the Decree of the President of the
Republic of Uzbekistan dated September 19, 2007. No. 3923 "On main directions of further


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deepening reforms and implementing the State Program of development of public health" and
the Decree of the President of the Republic of Uzbekistan dated October 2, 2007, No. 700
"On measures to improve the organization of medical institutions of the republic".

By the resolution of the Cabinet Ministers of the Republic of Uzbekistan No. 145 dated May
25, 2009 organized six Republican specialized scientific-practical centers (including
RSNPMTS Obstetrics and Gynecology and RSMNPTS Pediatrics).

To further ensure the health of women of childbearing age, to ensure birth of a healthy
generation the Ministry of Health, the Women's Committee of Uzbekistan is continuing to
implement the activities specified in the Decree of the President of the Republic of
Uzbekistan No. 1096 dated 13 April 2009. "On additional measures to protect the health of
mother and child, to create a healthy generation", the organization wide outreach and
awareness among the population on the formation of a healthy family, maternal and child
health and the realization of the target: "Healthy mother - healthy child" and in the Decree of
the President of the Republic of Uzbekistan No. 1144 dated 1 July 2009 "On the Program
of measures to further strengthen and improve the efficiency of the process to improve
reproductive health, birth of a healthy child, the formation of physically and spiritually
mature generation for 2009-2013.", measures which aim to:

- Improvement of the system of reproductive health, creation of necessary conditions for a
healthy baby;

- Further strengthening the material-technical base of obstetric care, maternal and child
health, primary health care facilities to provide medical care for mothers and children;

- Increased awareness among the public about the birth and upbringing of healthy children,
the formation of young people striving for a healthy and happy family, healthy lifestyle;

- Provision of the necessary conditions for the full physically healthy and spiritually mature
youth;

-Training of medical personnel working in the field of maternal and child health, improving
the quality of medical care for mothers and children.

In the republic in 1993, was adopted the regional program "Urgent measures to improve the
health of women of childbearing age," which was provided for the organization of annual
checkups to identify women with risk factors and their rehabilitation and provide increased
access to modern contraceptive methods.

Successfully implemented in collaboration with UNFPA country program and subprogram
"Strengthening the network of reproductive health services and improving management
capacity at all levels of the reproductive health", implemented during 2005 to 2009. The aim
of reproductive health programs is to achieve greater use of services in reproductive health of
women, men and adolescents. Organized the National Center for Reproductive Health, and
opened its branches in all regions, whose main task is to conduct educational and methodical
training in the field of reproductive health services, introduction of international standards for
the provision of services in RH which were adopted by the Country Programme for 2010-
2015.

For the purpose of improvement of women of childbearing age and to prevent unwanted
pregnancies and longer intervals between births by the Government organized the free


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provision of all modern contraceptives. If in 1991, only 13 percent of women of childbearing
age consistently used certain types of contraceptives, in 2009, 60-65% of women who are
married, use contraception.

Contraceptives in Uzbekistan are supplied mainly by humanitarian lines, carried out at the
expense of the United Nations Population Fund (15.0 million U.S. dollars), within the
framework of financial cooperation between Uzbekistan and Germany (Euros €5·2
million). In addition, for 2003-2009 more than 1034 million Uzbek Soums were provided by
the Council of Ministers of the Republic of Karakalpakstan, regional and Tashkent city
budgetary funds for the purchase of contraceptives.

In recent years, abortion rate fell from 39.9 to 6.5 ppm. Abortions are legal and available in
the facilities providing obstetrical and gynecological care.

The country established an integrated system of prevention and early detection of congenital
and hereditary diseases in children. The country has 12 screening centers: in the cities
of Tashkent, Samarkand, Bukhara, Andijan, Namangan, Fergana, Karshi, Termez, Urgench,
Navoi, Nukus and Jizzakh.

As a result of intense actions rate of child birth with congenital anomalies has decreased
by 14%.

Attention should be drawn to the MDG 6, which aims combating HIV / AIDS,
tuberculosis and malaria. The objective of this goal is to halt the spread of HIV / AIDS, and
begin to reverse incidence by 2015. It is known that the world is a tendency to stabilize and
reduce the spread of HIV infection. The exceptions are the countries of Eastern Europe and
Central Asia. The prevalence of HIV - infection in the Central Asian countries in particular in
the Republic of Uzbekistan, unfortunately not yet reached the stage of stabilization and is
located on the second, the concentrated stage of development.

Today, in Uzbekistan, the number of persons living with HIV has reached 15 892
people. HIV cases reported in all regions of the country and the largest number is registered
in Tashkent city, Tashkent and Andijan regions. The main way of transmission is through
injecting drug use, although there has been an increase in cases of sexual transmission of
HIV.

Currently in the Republic of Uzbekistan, introduced and implemented various programs
aimed at raising public awareness on HIV prevention and stigma and discrimination against
people living with HIV. These programs and activities carried out in accordance with the
Strategic Programme to prevent HIV - infection in the Republic of Uzbekistan for 2007 –
2011 years. Uzbek Law "On prevention of disease caused by the human immunodeficiency
virus (HIV)” dated 19.08.1999, "Rights and social protection of persons infected with HIV -
infected and their families" provides for humane treatment, provision of free medical care and
social security in the manner provided by law.

2) Organizational changes.

UARH continues to be the member of the working group in the framework of the National
Association of NGOs RUz, working in accordance with the Strategic Plan on Activities in
Uzbekistan combating HIV/AIDS in 2007-2011.




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UARH was included as the main partner of Country Programme Action Plan 2010-2015 for
the Programme of Cooperation between the Government of the Republic of Uzbekistan and
the United Nations Population Fund. Thus Co-financing Agreement between UNFPA and
IPPF EN have been signed for allocation of $92 887 ( ninety two thousand eight hundred
eighty seven US dollars- 2011) for implementing several sub-projects with UARH:
    1. Male involvement into reproductive health and rights issues in Uzbekistan
    2. Increasing public awareness on national documents/legislation on reproductive health
        and rights in Uzbekistan
    3. Scaling up peer to peer education on health issues among youth in Uzbekistan

UARH collaborating partners: UNFPA, GIZ, UNIFEM, UNAIDS, GFATM, ministry of
Public health of RUz, ministry of High and Special Education of RUz, Ministry of Justice of
RUz, Reproductive Health Center, Republic AIDS Center, Civil Society Support Center,
National Association of Breast Cancer “For life”, NGO “Istikbolli Avlod”, Women’s
Committee of RUz, Institute of Health and Statistics under the Ministry of Public.

As a positive outcome we can consider continuation cooperation with several NGOs and
governmental structures. MoU between the National Association on breast cancer, NGO
Women’s Assembly and the Institute of Health and Statistics of the MOH RUz have been
signed on mutual cooperation on the issues of SRHR for the purpose of increasing of all
efforts in providing activities in the framework of the project “Cancer prevention of
reproductive bodies of women’s of fertile ages in the Fergana valley”. IPPF EN again
supported $ 5 000 (Five thousand US dollars) for the purpose of this project implementation.
It was the second opportunity to receive IPPF EN funds strictly to UARH bank account since
2007.

UARH volunteers and trainers, who have participated in IPPF projects continue their
activities and confirm their commitment for further UARH mission realization in Uzbekistan.

UARH have been selected as a main partner to implement strategic plan on HIV/AIDS,
especially in the work with such vulnerable groups of population- IDUs.

Also UARH contributed to the preparation of Reproductive Health Law in Uzbekistan, which
is now under consideration of the Uzbek Parliament (Oliy Madjlis)

In June 7, 2011 UARH have conducted Regular General Meeting on the results of the 2010
year.

It was noted that it was a period of remarkable changes and that in spite of many difficulties;
the Association continued its activities.
In general information and educational measures taken by the Association within the realized
programs and projects have improved the understanding and awareness on reproductive
health, maternal and child health, education for family life.

Reproductive health and family planning are among the issues that relate to the same extent,
both men and women. However, existing programs so far have mostly been aimed primarily
at women; therefore it was to continue to build their work for the greater male involvement in
reproductive health issues.

In total, for the year 2011 all UARH branches covered more than 50,000 people:




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  General Meeting of UARH -1, Board Meetings of UARH -4, trainings/workshops –119
  (3570 persons), round table discussions – 19 (400 persons), maraphones/actions – 10 (3000),
  publications in Mass Media – 10, radio broadcasts – 6 and TV - 5, informational discussions
  - 7 (75 persons), cascade trainings – 1225 (more than 10 000 persons), consultations – more
  than 700, informational meetings – 1300 (115 persons).
  Thus during implementation of those project more than 50 000 persons have been covered.
  .

  3 UARH Board meetings have been conducted; the governing Board combines 10 members,
  one of whom is under 25 years old.

  The staff of Association consists of 4 people.

  3) Volunteer development. There are 652 members in UARH (420 women and 232 men).

  UARH has its structural branches in followings regions of Uzbekistan: Andijan, Djizak,
  Karakalpak, Khorezm, Namangan, Navoi, Samarkand, Surkhandarya, Tashkent, and Fergana
  .These branches are governed by the local Board members, youth group leaders and volunteers.

  The youth groups under the leadership of their youth leaders run each branch (247 person:
  female – 158, male - 89). They are actively involved into the preparation of project proposals
  and implementation of all activities and projects of Association in the issues of SRHR and
  HIV/AIDS/STI prevention, mainly on peer-to-peer basis. They also contribute and participate
  in YSafe and YPeer networks and volunteer involvement

  It is important for us to maintain the interest and to keep this pool of volunteers and
  professional specialists in Association, especially bearing in mind that UARH is the Full
  Membership of IPPF since 2005.

  4) Resource Mobilization

  In 2011 UARH was able to attract funding from IPPF EN/UNFPA, World Bank, SISF and
  Parliamentarian NGOs Support Foundation of Uzbekistan.

  Fundraising from international, local and private donors is still a major issue for our
  Association. Taking into consideration the limit of international donors in the country UARH
  tries to do their best to be included in realization of different partner projects.


5) Collaboration with other MAs

  UARH have continued partnerships with MAs from Kazakhstan, Kyrgyzstan, Tajikistan,
  Georgia, etc.

  In 2011 as a positive outcome we can consider including of Mrs. Nazarova Rakhima, UARH
  President, into Executive Committee of IPPF EN and participation in Accreditation Group
  IPPF EN; activities in which she actively participated in those activities.


  6) Programmatic areas – case studies



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In total, for the year 2011 all UARH branches covered more than        50 000 people:
General Meeting of UARH -1, Board Meetings of UARH -4, trainings/workshops –119
(3570 persons), round table discussions – 19 (400 persons), maraphones/actions – 10 (3000),
publications in Mass Media – 10, radio broadcasts – 6 and TV - 5, informational discussions
- 7 (75 persons), cascade trainings – 1225 (more than 10 000 persons), consultations – more
than 700, informational meetings – 1300 (115 persons).
Thus during implementation of those project more than 50 000 persons have been covered.

UARH have implemented the following projects:
Project, financed by SISF
“Cancer prevention of reproductive bodies of women’s of fertile ages in the Fergana valley”.

The aim of the project: Cancer prevention and awareness among women of fertile age in the
prevention of cancer of the reproductive bodies by training leaders of mahallas of Fergana
valley (Andijan, Namangan and Fergana regions).

General information:

Geography of the Project: 90 mahallas of Fergana valley.

Project implementation period: July - December 2011.

Target group: women of fertile age

Informed more than 9,000 people

Project partners:

      Republican Charity Fund "Mahalla"
      Institute of Health and Medical Statistics at the Ministry of Health RU
      The Women's Council
      The National Association of Breast Cancer.”In the name of Life”

       Donors

      SISF
      IPPF European Network

Project Results: Study among 300 women of childbearing age in the 3 regions (Andijan,
Namangan and Fergana Uzbekistan) with respect to their awareness and needs in the
prevention of cancer of the reproductive bodies was conducted.

Ccounseling service for women of childbearing age in the prevention of cancer of the
reproductive organs was organized, and also hot line "help and assistance." have been
operated during the project.

90 leaders in 90 mahallas have been trained

More than 900 information sessions by trained trainers among the leaders on the prevention
of cancer, together with volunteers of Fergana, Andijan, and Namangan branch of UARH in
90 pilot mahallyas of Fergana valley have been conducted,



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Total coverage of the target group over 9000 women of fertile age

Project, financed by UNDP/GFATM
UARH was a partner implementation of the project “Continuing scaling up of the Response
to HIV in Uzbekistan, with Particular Focus on most at Risk Populations”.
Project was mainly directed on the increasing of services quality for IUDs.

Besides that, several projects have been prepared by UARH branches- Navoi, Khorezm to
World Bank, and Karakalpak to Parliamentarian NGOs Support Foundation of Uzbekistan.


Information on project UNFPA/IPPF “Improving access of population to quality
information and services on reproductive health and rights”.




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                     Template for Case Study Reporting
Name      of   implementing    Member UARH/UNFPA
Association(s)
Name of project\action                   Improving access of population to quality
                                         information and services on reproductive
                                         health and rights
                                         3 sub-projects:
                                             1. Male involvement into reproductive
                                                health and rights issues in
                                                Uzbekistan
                                             2. Increasing public awareness on
                                                national documents/legislation on
                                                reproductive health and rights in
                                                Uzbekistan
                                             3. Scaling up peer to peer education
                                                on health issues among youth in
                                                Uzbekistan


Timeframe of project\action             January – December, 2011
Donor                                   IPPF EN
Budget                                  $ 92,887.00
Strategic Objective (which    Advocacy, Gender Equality, reproductive rights and


                                                                               10
Adolescents, Access, AIDS)                         the empowerment of women and
                                                   adolescent girls promoted through an
                                                   enabling socio-cultural environment that is
                                                   conducive to male participation and the
                                                   elimination of harmful practices

Contact for more information

Description:

Uzbekistan the most populous country in Central Asia with a population of 26,5 million has
crude birth rate of 20,4 per thousand . 48% from the whole population are men.

Today we can note that in Uzbekistan there is revaluation of the significance of health and
reproductive health in particular.

At the same time, the certain problems in the field of creation necessary for provision of full-
value health of women and men of reproductive ages, effective fulfillment of state guarantees on
implementation, safeguard and protection of the sexual and reproductive rights of citizens are not
solved. Both subjective and objective evidence stipulate a charter and specificity of these
problems. On the one hand, the solution of the problems in the field of reproductive health does
not depend on common people and more often is connected with social and economic conditions
of the country, in particular of concrete oblast, region. On the other hand, they are influenced by
socio-cultural values and purposes, stereotypes of consciousness and behavior that prevail in the
given specific society.

Taking the above mentioned into consideration it is necessary to change this vision on the
problem, because in our country men considers that only women herself must be responsible for
SRHR issues and it is not priority for men.

Besides that there is a lack of knowledge of sexual and reproductive health and rights issues in
general. Sometimes people, mainly men are unaware of the risk of infection through sexual
activity. Taking into consideration the results of conducted surveys by the UARH, we can note
that the knowledge of population and youth in the field of sexual reproductive health are still poor
and not sufficient and a lot of needs regarding family planning and using of different methods
of contraception remains mostly unsatisfied for women and men as well.

In this connection, it is necessary to implement special informational - educational programs,
directed on overcoming of traditional taboo on the SRHR issues, providing of qualified
information, regarding sexual reproductive health and rights, including using modern methods of
contraception also involving men to those issues, which are of great importance.

Objectives and results:
 Gender equality, reproductive rights and the empowerment of women and adolescent
girls promoted through an enabling sociocultural environment that is conducive to male
participation and the elimination of harmful practices.

   Expected results 1: 3000 men in Andijan, Namangan and Fergana regions of Uzbekistan
   are involved in sexual and reproductive health and rights (SRHR) issues and demonstrate
   positive attitude and practices regarding SRHR.




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   1) To conduct surveys among men in local communities in the beginning and in the end
   of the project.
   2) To conduct a 2 day ToT for 30 trainers from 3 selected regions (Andijan, Namangan
   and Fergana provinces) on STI and HIV/AIDS prevention and gender issues in
   Namangan city.
   3) To conduct a 2 day TOT for 30 trainers from makhallya leaders in the local
   communities from Andijan, Namangan and Fergana cities on STIs and HIV/AIDS
   prevention and gender issues.
   4) 300 information sessions for men in the local communities from Andizhan, Namangan
   and Fergana regions.

   Expected results 2: Creation of population perception and adherence to reproductive
   health and rights issues.

   Expected results 3: To increase areas of youth volunteers through the provision of high
   quality, accessible reproductive health and rights information on peer to peer bases in 3
   selected regions (Tashkent, Navoi, Samarkand & Karakalpakistan)
   1) To increase the awareness of adolescents and youth from medical colleges to
   reproductive health and rights, HIV/AIDS, STI and TB prevention on peer to peer bases.
   2) Develop effective partnerships and platforms for cooperation with peer to peer
   movement in the country.

Overall results

UNFPA implemented a project “Improving access of population to quality information and
services on reproductive health and rights” in partnership with local NGO Uzbek Association
on Reproductive Health (UARH) co-financed by International Planned Parenthood
Federation, European Network (IPPF,EN) and one of the sub-projects was "Male
Involvement into SRHR issues". Within the framework of this sub-project 4 Trainings of
Trainers were conducted by national trainers on "Male Involvement into SRHR issues". In
total 60 makhalla advisers (local community leaders) were equipped to deliver information
session in their makhallyas (local community) on male Involvement into SRHR issues.
Subsequently an audience comprising of more than 3,000 men living in makhallyas of
Fergana Valley (Andijan, Namangan and Fergana regions) were covered with educational
sessions held in makhallyas and received comprehensive knowledge on SRHR, male
contraception, family planning, gender issues and preventing STIs and HIV/AIDS.

Additionally, witihin the frames of the sub-project “Creation of population perception and
adherence to reproductive health and rights issues”, 3 day ToT was conducted in Tashkent
and 20 trainers were prepared from 10 regions of Uzbekistan. Subsequently these prepared
trainers conducted 2 day trainings in their respective regions for makhallya advisers (in 10
regions, per 20 people) on SRHR, male contraception, family planning, gender issues and
preventing STIs and HIV/AIDS. Total of 200 makhallya advisers are trained. Further, these
advisers are giving quality information to the population of their makhllyas on SRHR, male
contraception, family planning, gender issues and preventing STIs and HIV/AIDS.

Furthermore, witihin the frames of the sub-project “Scaling up peer to peer education in
Uzbekistan”, 5 day ToT was conducted in Tashkent for 20 participants from four regions (per
5 from Tashkent, Samarkand, Navoi and Republic of Karakalpakistan) on Peer to Peer
education. In order to develop effective partnerships and platforms for cooperation with peer
to peer movement in the country half day orientation meetings were conducted in regional
centers of each project regions (Tashkent, Samarkand, Navoi regions and Republic of


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             Karakalpakistan) with participation of representatives of regional Education, Health
             departments, AIDS Center, STI clinic, “Makhallya” foundation, Womens Committee,
             directors of colleges and lyceums and interested partners. Consequently these prepared peer
             educators are conducting information sessions and discussions for students in colleges and
             lyceums of their respective regions on healthy lifestyles, preventing STIs and HIV/AIDS and
             gender issues.

             Main activities and achievements:
Activities                                           Implementin      Timetable             Description of the
                                                     g Partner/s                            activity and results
                                                                      1q   2q     3q   4q
Male involvment into SRHR issues in Uzbekistan
Conducting a survey amongst men in local                                                    Survey       conducted
communities in the 3 selected regions (Andijan,                                             amongst men in local
Namangan and Fergana) in 2011 at the beginning                                              communities of the 3
and at the end of the project. This Survey will be                                          selected        regions
conducted by the specialist from sociological                                               (Andijan, Namangan
agency - "Center of Public Opinion" who is                                                  and Fergana) in April,
experienced in such kind of researches.                                                     2011 at the beginning
                                                                                            of the project in order
                                                                                            to     identify     the
                                                                                            knowledge of . Survey
                                                                                            was conducted by the
                                                                                            specialist        from
                                                                                            sociological agency -
                                                     UARH                  X                "Center of Public
                                                                                            Opinion", Mr. Marat
                                                                                            Khadjimukhamedov
                                                                                            and Igor Bokun, who
                                                                                            are experienced in
                                                                                            such       kind      of
                                                                                            researches. (300 men
                                                                                            are surveyed)
                                                                                            The second part of the
                                                                                            survey, at the end of
                                                                                            the project will be
                                                                                            conducted on first
                                                                                            quarter of 2012.

Conducting 2-day ToT for 30 trainers from 3                                                 2-day ToT for 30
selected regions (Andijan, Namangan and                                                     trainers     from     3
Fergana) in Namangan. The trainers will be                                                  selected regions (per
selected from UARH prepared trainers, who                                                   10      people    from
wishing act on providing of SRHR information                                                Andijan, Namangan
including STIs and HIV/AIDS prevention, male                                                and Fergana) was
contraception and gender issues.             UARH                          X                conducted            in
                                                                                            Namangan.          The
                                                                                            trainers were provided
                                                                                            by information on
                                                                                            SRHR including STIs
                                                                                            and         HIV/AIDS
                                                                                            prevention,       male


                                                                                                      13
                                                                         contraception        and
                                                                         gender issues.




Conducting three 2-day TOTs in selected                                  Three 2-day TOTs in
communities      (Makhallyas)      of    Andijan,                        were held in selected
Namangan and Fergana regions. The participants                           communities
will be selected from leaders of Makhallyas and                          (Makhallyas)         of
managers of local clinics on the issues of SRHR                          Andijan, Namangan
including STIs and HIV/AIDS prevention and                               and Fergana regions.
gender issues. (30 people are trained)                                   The participants were
                                                                         selected from leaders
                                                                         of Makhallyas and
                                                      UARH   X           managers of local
                                                                         clinics and they are
                                                                         provided           with
                                                                         information on the
                                                                         issues    of     SRHR
                                                                         including STIs and
                                                                         HIV/AIDS prevention
                                                                         and gender issues. (30
                                                                         people are trained)

30 prepared trainers will conduct per 5                                  30 prepared trainers
information sessions for men in selected local                           (10 from each region)
communities in Andijan, Namangan and Fergana                             conducted      per      5
regions in the premises of Makhallyas. Per 10                            information sessions
men will participate in each session in 2 selected                       for men in their
Makhallyas from 3 regions. In total 3000 men                             respective         local
will     be     involved    in    this     activity                      communities            in
(30x5x2x10=3000) in Makhallyas. IEC materials                            Andijan, Namangan
on the issues of SRHR will be distributed among                          and Fergana regions in
the participants.                                                        the     premises       of
                                                                         Makhallyas. In total
                                                      UARH       X   X   3000      men      were
                                                                         involved      in     this
                                                                         activity in Makhallyas.
                                                                         Trainers’     kit     for
                                                                         conducting         these
                                                                         information sessions
                                                                         were procured by
                                                                         UNFPA and delivered.
                                                                         IEC materials on the
                                                                         issues of SRHR were
                                                                         distributed among the
                                                                         participants.
Operational support to UARH branches,                                    IT equipment (PC,
procurement of IT equipment for Namangan,                                UPS, printer, scanner,
Andijan and Fergana branches.             UARH                   X   X   photo camera) for
                                                                         Namangan, Andijan
                                                                         and Fergana branches


                                                                                    14
                                                                                      of     UARH        were
                                                                                      procured            and
                                                                                      delivered.

IEC materials on male involvement are                                                IEC materials on male
developed/adopted, published and distributed                                         involvement      (flyer:
among the population.                                                                3000 in Russian and in
                                                                                     Uzbek, brochure: 3000
                                                                                     in Uzbek and a
                                              UARH                  X
                                                                                     journal:     500      in
                                                                                     Uzbek), are adopted,
                                                                                     republished         and
                                                                                     distributed among the
                                                                                     population.
Creation of population perception and adherence to reproductive health and rights issues.
Conductting 3 day ToT in Tashkent for 20                                              3 day ToT was
UARH trainers from 10 provinces (per 2).                                              conducted in Tashkent
Furthermore, 20 prepared trainers will conduct                                        for 20 UARH trainers
                                               UARH                    X
trainings in local communities(makhallya) in                                          from 10 provinces (per
their provinces.                                                                      2).     20       trainers
                                                                                      prepared.
20 prepared trainers will conduct 2 day trainings                                     20 prepared trainers
in local communities (Makhallyas) for makhallya                                       conducted      2     day
advisers in their provinces.                                                          trainings    in     local
                                                                                      communities
                                                    UARH                    X         (Makhallyas)          for
                                                                                      makhallya advisers in
                                                                                      their provinces. Total
                                                                                      of 200 makhallya
                                                                                      advisers are trained.
Scaling up peer to peer education in Uzbekistan
To conduct 5 day ToT in Tashkent for 20                                               5 day ToT was
adolescent and young people (per 5 from                                               conducted in Tashkent
Tashkent, Navoi, Samarkand & Karakalpakistan)                                         for 20 adolescent and
on peer education.                                                                    young people (per 5
                                                    UARH                    X
                                                                                      from Tashkent, Navoi,
                                                                                      Samarkand            &
                                                                                      Karakalpakistan) on
                                                                                      peer education.
To conduct snow-ball information sessions in 8                                        20     prepared    peer
selected medical colleges(Tashkent, Navoi,                                            educators conducting
Samarkand & Karakalpakistan) every month on                                           information sessions
the issues of RH and RR, HIV/AIDS. STI and                                            in selected colleges &
TB prevention and gender by prepared peer to                                          lyceums      (Tashkent,
peer educators of each region on voluntary basis.                                     Navoi, Samarkand &
                                                    UARH                         X
                                                                                      Karakalpakistan) on
                                                                                      the issues of RH and
                                                                                      RR, HIV/AIDS. STI
                                                                                      and TB prevention and
                                                                                      gender on voluntary
                                                                                      basis. Trainers kit


                                                                                                 15
                                                                                        were purchased by
                                                                                        UNFPA and delivered
                                                                                        to UARH branches in
                                                                                        order to be distributed
                                                                                        to peer educators for
                                                                                        the        information
                                                                                        sessions.
Monitoring activities
Monitoring of project activities by UNFPA                                               4 Field Monitoring
Programme Staff and National Counterparts.                                              Visit to Namangan and
Estimated                           budget:                                             Fergana,           Navoi,
Monitoring missions = $6, 500                                                           Khorezm               and
                                                                                        Samarkand         regions
                                                                                        was conducted to
                                                                                        monitor implemetation
                                                                                        of the trainings.

        Main constraints:
        Commitment of national partners and national ownership of the government is key to
        successful implementation of project. Continuous advocacy efforts and support for capacity
        building is crucial to establish enabling environment for promotion of gender equality in the
        country.

        Involvement of civil society created expanded access to male audience and was fully
        supported by stakeholders involved.

        Women and adolescent girls in regional centers have more access to the information related
        to RH and RR issues than in district levels.

        Continuous advocacy efforts and building capacity of national partners is significant even in
        the difficult national context, where gender issues are sensitive and not promoted for
        discussion.

        Lack of IEC materials and media coverage promoting male involvement into SRHR issues.
        Low capacity of partners to work in the area of male involvement in SRHR issues and reach
        out to communities to implement such projects.

        Conducting trainings and information sessions on RH and RR in district levels require more
        financial resources.


        Quality and Quantity of Technical Support in the Course of the Year.

        Adequate and effective technical support was provided by UNFPA staff to the project.
        NPO on Gender and Youth Issues provided overall coordination and facilitated
        implementation of the programme. UNFPA Uzbeksitan Admin/Finance Assistant
        assisted implementation of project activities.


        The project actively used technical expertise of the staff of the Uzbek Association of
        Reproductive Health for designing and conducting training activities.



                                                                                                   16
IV. Future Workplan


Continue supporting the efforts of the national partners, including strengthening capacity of
partners, on the project project “Improving access of population to quality information and
services on reproductive health and rights” including sub-project "Male Involvement into
SRHR issues", and expand the project to other regions. Develop IEC materials to aid the
project on "Male Involvement into SRHR issues" (translating the Manual into Uzbek
language and printing, development and distribution of IEC materials for information
sessions in the local communities).

Lessons learned

- In the Republic of Uzbekistan there is no officially adopted law on Reproductive Health.
Project have arise a lot of problems: reproductive and sexual health takes the important place
in the life of the people, but still for the majority of them this subject is still closed and
mainly rural population have no access to available information in this issue. Thus only open
discussion of this problem can result in changing reproductive behavior and incorrect attitude
and prejudices in sexual and reproductive behavior of the people and especially youth and
adolescents.

- Youth, adolescents and other target group of population have an access to trustworthy
information and services in the area of sexual and reproductive health and rights and family
planning



   -   Ensuring that the particular reproductive health needs of adolescents are addressed
       and youth-friendly services provided.

   -   Working with communities, including local political and religious leaders increased
       public awareness of the reproductive and sexual health issues affecting adolescents
       and other vulnerable groups.

   -   Mobilizing the support of decision makers at all levels to support programs aimed at
       improving adolescent sexual and reproductive health is of great importance.

   -   Providing life skills and counseling so that adolescents are aware of their rights and
       know about available services.


   -   Youth participation and youth-adult partnerships are essential for program relevance
       and effective use.

   -   Prevention of HIV/AIDs, STI, early pregnancy should be addressed together
       educationally and in service related programs with an emphasis on safer sex practices
       and protection.


   -   Policy makers, government leaders and civil society leaders must be involved in
       establishing positive policies and programs (Elaboration and adopting of
       Reproductive Health Law in the country.)


                                                                                           17
-   Better program models for reaching youth and rendering services for them must be
    disseminated and made available so all can learn this experience.




                                                                                 18

				
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