Členská organizácia International Planned Parenthood Federation (IPPF)
The Slovak Family Planning Association’s (SSPRVR) 2004-2008 strategic plan is aimed to implement the IPPF’s sexual and reproductive health vision in the Slovak conditions. Our plan is based on the same values, visions and strategies as the IPPF‘s and therefore it includes five interconnected strategies listed below:
- Protection of freedom of choice and basic human rights
- Support to health and safer sex and the gender equality
- Prevention of unwanted pregnancy and sexually transmitted infections including HIV/AIDS
- Access to high-quality services
- Participation in the active involvement of all individuals and institutions with similar values and goals
Slovak FPA Mission
Promotion of basic human rights of men and women to be able to make a free and well-informed choice in sexual and reproductive life; protection of the right to access to correct information, to education based on current scientific knowledge and to access to high-quality sexual-health and reproduction-health services
which express the conceptual framework of relationships between the IPPF EN-defined vision, values, mission and strategy tailor-made to suit the conditions in the Slovak Republic is as follows:
- Access to the education, information and services
- Sexually transmitted infections including HIV/AIDS
- Advocasy for free-choice as a human right
1. Access to the education, information and services
Present time analyse
In Slovakia, there is a legal access to sexual and reproductive health services that can be proved by positive development in sphere of abortion, maternal and new-born mortality, as well as upward movement in the contraception using, especially hormonal. In spite of the positive statistical evaluation based human rights are also threatened in Slovakia and the access to sexual and reproductive right are restricted in many cases. The same situation is considerable as regards availability of youth sexual education. Mentioned facts are interconnected with present political situation in the country, where increasing power of Christian Democratic (Catholic) Party is noticeable in parliament. International Treaty with Holy See enable Vatican to educate Slovak youth and impose its moral doctrine onto the citizen of the Slovak Republic, regardless of their religious beliefs or faith. This way run the risk of spread erroneous information in sphere of sexual and reproductive health and rights for example prevention sexually transmitted infections and unwanted pregnancy. In connection with abusing the Right to Exercise Objection of Conscience number of hospitals leaded by catholic director refusing to provide services in sphere like contraceptive counselling, abortion and genetic prenatal diagnostics. That person transmits consequences of his faith to the whole medical institution and affects the recruitment of doctors and other medical staff. This process hasn´t been controlled by state.
Another issue represented marginalized group of population, that means insufficient approach to sexual and reproductive health services, because of economical, cultural and other barriers. It concludes handicapped , underprivileged inhabitants and youth in general meaning. Special attention is necessary payed to refugees in view of living in camps and everyday stress, cultural, speech and educational problems. The same issues should be solved in case of Roma community.
Sexual and Reproductive Health Issue in Roma community
The so-called Roma problem in Slovakia has a historical, cultural and social background extending beyond territorial boundaries of Slovakia. Based on the analyses carried out at the meetings organised by the Inforoma foundation with its head office located in Bratislava and the US Dreyfus Health Foundation with its headquarters located in New York, the reasons why this problem occurs seem to be complexed. The Roma community is not homogeneous. That part of Roma community living in a segregated way, in settlements, often without basic property relations settled, without infrastructure, under unsuitable hygienic and social conditions, with a low educational and cultural level, is problematic. According to the analyses made at the meetings mentioned above, the high natality is one of the reasons why the existing situation is deteriorated. The high birthrate and multiparity result in children not being provided with health care, not obtaining adequate education and later in their lives, they are not able to acquit themselves well on the increasingly demanding labour market. A vicious circle arises, which continues to expand and brings about growing tension in the society.
The low level of sexual and reproductive health of the Roma community is a result of the following factors:
- unequal rights and position of Roma women in their family hierarchy,
- lack of information on how to control their fertility and/or lack of effort and support from the community side,
- lack of information and motivation to monitor their health in general and their reproductive health in particular – visiting pregnancy counselling centres, preventing oncological diseases, preventing sexually transmitted infections and inflammatory diseases of generative organs,
- lack of motivation in health care providers to actively solve the problems concerning sexual and reproductive health,
- discontinuation of visits paid by midwives, no possibility to advantage socially weaker groups in the access to the contraception,
- no possibility to advantage socially weaker groups in the access to the contraception.
Protection of the rights to make a free and well-informed choice in sexual and reproductive life, access to true information, to education based on current scientific knowledge, and access to high-quality sexual-health and reproduction-health services for everybody – men, women, mainly for marginalized group of inhabitants.
- To enable subsidy for modern contraceptives methods for marginalized, handicapped and other disadvantaged groups free of charge. change sexual and reproductive
- To initialize education campaign to behaviour to effective methods of planned parenthoods including emergency contraception.
- To force planed parenthood, ethics and reproductive rights as a compulsory subjects in pre and post gradual education for medical staff.
- To enforce sexual education in every type of schools as an minimum standard of objective knowledge grounded on curriculum of sexual education.
- To participate in preparation for legislation regarding informed consent and free choice for sterilization free accessible for women and men
- To initialize regular survey in sphere of sexual and reproductive health and rights of Slovak population.
- To advocate free access towards safety abortions for women in all regions of Slovakia
- To involve in pilot projects on quality of care for marginalized groups of people included Romas and refugees.
Present time analyses
Youth in generally doesn´t have enough information concerning sexual and reproductive health and rights. This lack results from inconsequently defined sexuality education and absence of minimal sexuality education. Teachers with insufficient personal and pedagogical qualities are involved into pedagogical process. In real life this shows e. g.: in fact, that in spite of the decrease of number of abortions in total population for the period of 15 years (71, 5 per cent) there are no changes in this population group. Number of pregnancies as well as number of abortions in the period of 10 years are still on the level of 9-10 per cent. Equally early start of sexual life without using contraception confirms, that recommendations of the UN in Cairo concerning the to improving of sexuality education at school are applyable also in Slovakia. Unwanted pregnancy, the risk of sexual violence, sexual abuse and STD are mean issues, that unprepared youth use to face.
Improve the situation in SRHR among adolescents
- Creation of the legislative framework inevitable for an appropriate care in the sphere of sexual and reproductive health and right of youth.
- Ensure the access to quality services in the area of sexual and reproductive health and right of youth.
- Decreasing the number of unwanted pregnancies concerning youth.
- Increasing health consciousness of the youth in the sphere of sexual and reproductive health and right with regard to conscious healthy life stile.
- To increase share of young people in programmes orientated towards improving sexual and reproductive health.
- In cooperation with governmental and non-governmental organizations working with the youth initiate national campaigns to decrease amount of unwanted pregnancies, STD HIV/AIDS included.
- At all school grades applying the sexuality education which will contain elements of minimal knowledge from the sphere sexual and reproductive health and right (the minimum of sexuality education) that all pupils and students regardless of the type of school have to obtain.
- In collaboration with governmental and non governmental organization with providing counselling for youth who are endangered by STD, unwanted pregnancy, sexual abuse and home violence. (counselling centres, helplines).
- Involving youth in activities of improvement sexual and reproductive health and rights.
Present time analyses
The most visible boom of abortions was in the end of the eighties. The reason was complexed – liberalization of the abortion law and absence of contraception and sexuality education. Later, in the sixties when contraception has appeared, attitude of the general public as well as professionals towards it was completely negative. Sterilization was and still is inaccessible because of legislative barrier. Economically more attractive was free of charge done abortion using in this time instead contraceptives.
Decision of the Slovak government about taxation of mentioned performance, has changed people´s attitudes towards such a form of contraception. The nineties are considerable by their changes in sexual and reproductive behaviour of the Slovak population. Great effort to decrease abortion majority came from medicals and non governmental organizations. In period as from the eighties to these days the decline of abortion is about 70 per cent. According to Health Statistical Office (UZIŠ) in 1989 were done 48 603 abortions on request of Slovak women, that means 43 abortions concerning 1000 women in fertile age. In 2002 there were 15 301 abortions done (10, 6 abortions concerning 1000 women). It is interesting, that in Slovak Republic in present time are less abortions done then in Scandinavian countries. In spite of increasing tendency among the contraception users in the part of Slovak population is still some type of mistrust towards contraception and planed parenthood. Mentioned tendency is supplied by theory about negative demographic evolution. In actual fact contraception using is not in close relation to the demographical decline (that means women´s emancipation, making career, postponing childborn to the latter age) but it connected with abortion decrease.
On the other hand relatively high amount of abortions among the women under 19 is frightening.
To receive some serious statistical data about sexual and reproductive health and rights regarding Slovak inhabitants are problematic too. There no systematical research have been done in this area. This kind of information is available just from partial researches. According to research agency Focus (see Focus: “Sexual Behaviour of Slovak women”, 1997) more than 1/3 of Slovak women (35,2 per cent) have their first sexual intercourse at the age of 17 and more than ½ (56 per cent) at the age of 18. The border of the first sexual activities has already moved under the age of 15 years. Generally it is true, that younger women have their first sexual intercourse earlier than older ones.
In spite of abortion decline as well as childbirth among the teenagers the proportion of abortions to the 1000 birth is constant in this age. Conclusions from UN conference in Cairo regarding of improvement sexuality education at schools are valid also in Slovakia. There is inevitable to fix minimal amount of knowledge concerning this field for all pupils and students have to obtain regardless of the type of school. There are some other issues, that these unprepared youth have to face, such as violence risks, sexual abuse, STD.
In above mentioned research (see Focus: “Sexual Behaviour of Slovak women”, 1997) great respect towards human rights is evident as well as strong will to decide about the number of their children and the right to choose abortion religious women included.
During the last 15 years number of hormonal contraceptives users has increased It is from 2 per cent in 1988 to 18, 5 per cent in 2002. On the other hand number of IUD users has declined from 15 to 7 per cent.
Keep abortion legal and accessible in Slovakia
- Keeping free and legal access to abortion services according to the medical knowledge standards.
- Ensuring the high-quality of abortion servicies
- Increasing responsibility of decision making and free choice in cases unwanted pregnancies including information about possible risk of abortion.
- Ensuring reasonable and accessible prices for abortion performance for marginalized groups.
- Except of traditional surgical way is inevitable to assert also access to the chemical way of abortion.
- To force system of financial help for marginalized group in case of abortions.
- Due to recommendations of WHO to create gender sensitive system of counselling focused to women after abortion. (In collaboration with non-governmental organizations and psychological centres for counselling).
- Preparing of the campaign dedicated to unwanted pregnancy prevention.
- Sexually transmitted infections including HIV/AIDS
Present time analyse
In Slovakia similarly than in other European countries the increase of some types of STD is evident. Especially syphilis prevalence has dramatically grown about 100 per cent since 1999.
After the gentle decline of the gonorrhoea (1996 – 2000), since year 2000 we can observe the increase again. For the other types of STD the statistical data are insufficient. Because of prevention oncologist disease, threat of the fertility is inevitable to follow the other ones (ureaplazma, urealyticum, chlamidie and papiloma viral infections) too.
Slovak republic belongs to the countries with relative low prevalence of HIV/AIDS. It is obvious that this tendency is just temporary. But neither general public in Slovakia is still prepared (insufficient sexuality education), nor professionals have communication strategy towards ill clients, as well as methodology of prevention of vertical infect the foetus through the mother.
Reduction of incidence of STIs and prevention particurlarly on AIDS
- To reduce occurrence of STD.
- To ensure the measures to prevent vertical infect the foetus through the mother.
- To improve the level of general public education in the area of STD prevention, HIV/AIDS included, concerning especially risk groups.
- To eliminate social discrimination HIV positive people, or people with AIDS.
- To support the children´s and youth´s prevention programmes.
- Supporting of creation the legislative framework inevitable for prevention of discrimination HIV positive people or people with AIDS.
- Initiating of the national campaign focused to the risk behavioural changes towards the STD and HIV/AIDS in cooperation with non-governmental organizations.
- Asserting of the early diagnostics and subsequent healthcare of STD and HIV/AIDS in surgeries of first-contact doctors, gynaecologist, dermatologist, urologist.
- To initialize creation of standard advancement to ensure prevention of vertical infect the foetus through the mother.
- Improvement of the communication of relevant non-governmental organization with marginalized groups (homosexuals, prostitutes).
- Advocasy for free-choice as a human right
Present status analyses
As it was mentioned above, reproductive health and rights (right to access to planed parenthood services and to true information in this area) in Slovakia are in permanent treat. Also implementation of the Action Program of Conference in Cairo beats against political and ideological resistance. Right to Exercise Objection of Conscience is abused as well. One of the mean issue in Slovakia is also violence against the women. In this case the breaking of the human rights is often doing inside the family, or partners life. Simultaneously with finding out the home- violence is necessary observation of the structures, institutions and systems of values in Slovak society.
Violence against the women in Slovak republic is widespread and has serious consequences for victims. It concerns all of the women regardless age, socio-economical status, region. Majority of home-violence victims expect their help from public institutions. It means the change of legislative rules concerning the home violence, as well as the possibilities how to help the victims (legal, social, medical, psychological, etc.) The result of the social consensus is that home violence is an important issue which should be solved.
Researches and surveys focused on the values put Slovak republic into countries with traditional priorities of the life with the distinguish role of men and women. This issue is still not so visible. To avoid the violence the prevention is necessary (education, campaigns). It is important to realise specialized researches orientated to the nature and consequences of mentioned issue.
The lack of interest to collaborate with non-governmental organizations in this sphere is still permanent. Neither financial nor moral support from the part of state institutions are sufficient. Cooperation on international level is limited by money. Lack of financial sources endangers the existence not only of non-governmental organizations, but whole philosophy of planned parenthood, sexual and reproductive health and rights in Slovakia. The activities of some governmental institutions and Catholic church threaten the activities of “pro choice” and could lead to the end of this organizations.
Advocasy for legal and accesible rights and servicies in whole scale of SRH
- To acknowledge sexual and reproductive rights as a basic human rights in Slovak republic.
- To keep readiness for action of non-governmental organizations working in area of sexual and reproductive health and rights.
- To assert consistent keeping of the right side of the AP ICDP, Peking+10, CEDAW and other documents UN and EU, ensuring sexual and reproductive rights.
- To creation of the legislative space and institutionalization of solving the violence in couple relations, sexual abuse and their prevention.
- Increasing of awareness and level of education regarding general public and professionals in area of home-violence and sexual abuse.
- To increase level of knowledge and informing of inhabitants about the white slave trade.
- To assert acknowledge sexual and reproductive rights as a basic human rights in cooperation with other non-governmental organizations in Slovak republic. To respect them in creation legislatives norms, ensuring medical services and education.
- Lobbing in Slovak parliament – collaboration with organizations engaged in “Interparliamental working group”.
- To assert the acceptance of National Strategy of Reproductive Health in Slovak Republic.
- To initialize national campaign oriented to negatives impact of women and children trafficking and its prevention, in collaboration with governmental and non-governmental organizations.
- To ensure collection and evaluation of the statistical data in the area of home-violence, violence in couple relations, women and children abuse.
- To initialize creation of asylum centres in all Slovak´s district for the victims of violence.
- To create the system of financial sustainability SFPA.
- To create an effective personal structure and coordination centre.
- To make the system of regional centres ensuring services delivery and advocacy of the free choice and human rights on local level.
- Keeping of the awareness professionals and general public by the own periodical publishing.
- Keeping of the interest of public in the field of sexual and reproductive health and rights via collaboration with media.
- To cooperate with professionals and non-governmental organizations to assert and advocate sexual and reproductive human rights and high-quality services.