Unmatched work has been undertaken in the Republic of Moldova to ensure that teenagers can access sexual and reproductive health services, following an organized procedure laid out by WHO.
WHO/Europe carried out an evaluation of sexual, reproductive, maternal, newborn, kid and adolescent health in the context of universal health coverage in 6 countries of the WHO European Region. This assessment recognized broad health system challenges that must be resolved to achieve universal health coverage in the location of sexual and reproductive health. It also pinpointed essential interventions for nations to prioritize, consisting of sexual and reproductive health services for teenagers.
During 20 and 22 October 2020 WHO and the United Nations Population Fund (UNFPA) will arrange a sub-regional consultation on sexual and reproductive health in Main Asian countries. The outcomes of the nation evaluations on sexual, reproductive, maternal, newborn, kid and adolescent health in addition to how to ensure access to sexual and reproductive services in the context of the COVID-19 pandemic will be key topics of discussion throughout this online occasion.
Republic of Moldova sets an example
The Republic of Moldova was the only country consisted of in the WHO/Europe assessment that uses extensive sexual and reproductive health services for youths. It developed youth-friendly centers in every district and town between 2002 and 2017.
These 41 centers provide free counselling services to young people aged 10–24, and are staffed with multidisciplinary teams of specialists consisting of gynaecologists, urologists/andrologists, internists, dermato-venereologists, midwives, nurses, psychologists and social workers. Adolescents likewise get free contraceptives and HIV testing.
In addition to the network of clinics, efforts are underway to establish mobile groups to provide medical outreach services to adolescents in towns.
Dr Galina Leșco, Head of the National Resource Centre on Youth-friendly Health Providers Neovita in Chisinau, coordinates the national youth-friendly clinic network. She states that the Ministry of Health’s dedication in addition to donor assistance from the Global Fund to eliminate AIDS, Tuberculosis and Malaria, the Swiss Firm for Development and Cooperation (SDC), the United Nations Children’s Fund (UNICEF) and WHO have actually been decisive in reinforcing services specifically for teens.
” The very first 3 pilot centres were opened with the financial backing of UNICEF Moldova. The SDC played an essential role in extending the network throughout the past years. Thanks to WHO’s technical support, a scaling-up principle for youth-friendly services was developed,” discusses Dr Leșco.
” We get amazing support from WHO and appreciate how we are continuously assisted in the development of service-quality requirements and in implementing ingenious approaches, such as collective knowing.”
Positive patterns, legal challenges
According to the Health Behaviour in School-aged Kids research study in the Republic of Moldova, in the last 5 years the fertility rate of those aged 15–19 has actually decreased by 25%, and abortions in this age group have reduced by 20%. The number of abortions among minors has actually nearly halved in the last 3 years, from 243 in 2016 to 141 in 2018.
Another positive advancement is seen in several research studies showing that the proportion of 15- year-olds who have actually begun making love reduced from 18%in 2014 to 13.3%in2018 The use of the contraceptive pill amongst sexually active 15- year-olds increased from 6%in 2014 to 10%in 2018.
Nevertheless, a number of difficulties remain. The occurrence of HIV among young people has remained the very same in the last few years, and prophylactic use among sexually active young people aged 15–17 is irregular. Inadequate financial support for youth clinics is an additional issue.
” Every year we have significant personnel losses due to the bad monetary circumstance in the nation,” says Dr Leșco. Numerous health employees from the Republic of Moldova migrate to other countries with the hope of securing greater pay and enhanced working conditions.
Dr Leșco is eager to evaluate Moldovan legislation related to the age of consent to access health services. The existing legislation requires adult permission for those aged 16 years and under. “The requirements for examining the decision-making capabilities of a young person should alter so that, under certain conditions, youths can have simpler access to quality services,” she states.
The WHO assessment likewise showed that not all health companies know about the relevant policies or how to apply them in young people’s benefits. One of the evaluation’s policy suggestions is that legislation on adolescents’ right to access to sexual and reproductive health services without adult consent be plainly communicated to all health workers to ensure that it is understood and used uniformly throughout different levels of care. It is also essential that youths understand their rights and entitlements.
Reaching every young adult, in every village
” A big issue today is that young people from little, remote towns are ashamed to request for the help they require in the regular regional health services,” adds Dr Leșco. The strategy to develop mobile groups will address this concern and make sure privacy and confidentiality in small neighborhoods.
” The groups will consist of nurses and volunteers who regularly check out the communities based on a recognized programme. Like this, youths will take advantage of more confidential services, free of charge,” she explains.
Ms Alina Racu, a girl from Criuleni in the central part of the nation, validates that a lot of work remains to notify young people in small towns about sexual and reproductive health and the possibility of accessing services in the youth-friendly clinics.
” Numerous young people in villages don’t understand about the basic techniques of birth control and don’t know where to opt for assistance,” she states. “The majority of them look for services on socials media, like Facebook, Odnoklassniki or other websites. It’s totally various when you go to a qualified expert, who explains in detail the dangers, challenges and ways of safeguarding yourself. It’s really important for teenagers to understand about these centres and not hesitate to request for qualified help on time.”
Making a distinction in young lives
Lots of health professionals at the youth-friendly centers have modest working conditions and low wages. Despite such challenges, they discover satisfaction and terrific worth in their work.
” I will always remember when our centre, Neovita, celebrated its 10- year anniversary. A young girl concerned the reception and I saw from her clothes and look that she probably lived on the streets. She wanted to make a visit with a gynaecologist at the suggestion of her buddy, who had visited the centre previously. This pal had a psychological health issue and had needed an abortion when she was 14 years of ages,” remembers Dr Leșco.
” I realized that if this girl encouraged a friend to visit us now, it means that when she was here, she felt safe with us, considered us as good friends and received the help she needed. This makes us happy with our accomplishments, no matter how little they may be.”
The outcomes of the evaluation of sexual, reproductive, maternal, newborn, child and adolescent health in the context of universal health coverage in 6 countries, consisting of the Republic of Moldova, are readily available through the link listed below.