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“My life is my students and those several thousand babies whom I have helped to come into this world,” says Nina Kayupova, gynaecologist and obstetrician, Doctor of Medical Sceinces, professor, honored worker of sciences of Kazakhstan.

 

 “I've dreamed of being a doctor since I was a fourth-form pupil, which is when I saw a picture of a female doctor on the cover of “Ogonyok” magazine” (Soviet weekly).

Nina Kayupova has since dedicated her life to serving motherhood. She has a lot of innovative solutions in the area of obstetrics and perinatal medicine. For example, under her leadership a whole new school of thought in medicine was formed that deals with the environmental impact on reproductive health. The research behind this innovation helped identify specific impacts of unfavourable environment on the health of girls, women and the future generations. Besides, markers for environmentally unsustainable areas have been developed and programmes to prevent the consequences of such impacts have been detailed.

1960s vs. Cairo 1994

In the 1960s, as mortality rates declined around the world, some researchers and policymakers grew panicked that population growth would outstrip natural resources, leading to famine and societal collapse.   Up until 1994 many countries approached population issues by trying to either lower or raise the number of people based on fertility-controlled targets. In other words, figures were more important than people. In September 1994 in Cairo at the International Conference on Population and Development (ICPD) the global community agreed that people, rather than figures, should be put at the centre of sustainable development. This meant that from then onwards every person had a right to make a free and informed choice over when, how many and how often to have children. Nina Kayupova represented Kazakhstan at the Conference. Kazakhstan was one of 179 states who adopted the ICPD Programme of Action, which turns 25 this year.

 

“There were 10 thousand participants at the Conference. We debated every figure, every letter and every sentence of the Programme of Action. Of course, population and development is a very topical and sensitive issue. This is because population, the quality of people, quality of human resources and workforce define sustainable development of a country,” says Nina Kayupova.

 

Right to Choose

Because the commitments made at ICPD started to be translated into tangible actions, many acquired an opportunity to better plan their lives, especially women and girls.  For example, ten-year old girls back in 1994 have now become 35-year old women of reproductive age. Many of these women had access to knowledge about how to protect oneself from sexually transmitted infections or an unintended pregnancy. As a result, these women became mothers when they felt they were ready for it, and many managed to also fulfil their career ambitions, as well as achieved some other personal goals. Put differently, the ICPD Programme of Action has helped women and girls use their right to decide for themselves how they wanted to live their lives.

 

Youth of Kazakhstan and reproductive potential

Kazakhstan’s young people aged 15-24 comprise 15 percent of the population. Their current quality of life will define the future of the whole country.

“That’s why today we should be talking not only about reproductive health, but about an entire system known as reproductive potential, says Nina Kayupova. – What does it mean? It encompasses reproductive rights and reproductive health. In Kazakhstan the highest activity in terms of birth-rate is observed in the age group of 25 to 29, peaking at 25, which translates into 180 births per every 1,000 women of this age group.”

Meanwhile, the latest sociological survey has shown that in Kazakhstan around a third of adolescents aged 15 to 19 are sexually active and many practice unsafe sexual behaviour. For instance, 91% of young people surveyed don’t have sufficient knowledge about HIV and AIDs. 25 out of every 1,000 girls aged 15 to 19 give birth, meaning that there are a lot more teenage pregnancies than this figure. One out of ten women who is married or in union and fertile but wishes to delay having children doesn’t have access to modern contraceptives or family planning services.

 

So, how can we help young people protect themselves now and maintain reproductive health in the future?

 

A separate chapter of the ICPD Programme of Action is dedicated to youth (6.15):

 

“Youth should be actively involved in the planning, implementation and evaluation of development activities that have a direct impact on their daily lives. This is especially important with respect to information, education and communication activities and services concerning reproductive and sexual health, including the prevention of early pregnancies, sex education and the prevention of HIV/AIDS and other sexually transmitted diseases. Access to, as well as confidentiality and privacy of, these services must be ensured with the support and guidance of their parents and in line with the Convention on the Rights of the Child. In addition, there is a need for educational programmes in favour of life planning skills, healthy lifestyles and the active discouragement of substance abuse”.

2019 is declared the Year of Youth in Kazakhstan. The country is taking active measures to empower young people. A large international conference “Investing in Youth. Leaving No One Behind” took place in Nur-Sultan last year. A Declaration of the same name was adopted, and its separate parts focus on reproductive health of young people.

This year UNFPA’s flagship report zooms in on the unfinished business of ICPD. For countries that signed the Cairo conference’s Programme of Action this is an opportunity to discuss what other steps are needed to complete the unfinished business and, indeed, leave no one behind.