ALMATY, Kazakhstan “It was my first time with my boyfriend. We didn’t use condoms,” 17-year-old Amina* told UNFPA at one of the youth health centers in Almaty, Kazakhstan’s largest city.
Her school curriculum did not include comprehensive sex education, and she did not feel comfortable raising such issues with her family. So when her menstrual cycle didn’t come as expected, she Amina panicked. In two weeks, I realized I was late. I was freaking out. I was 16 at the time and there was no way I could talk to my parents or teachers.”
A decade ago, youth-friendly health services—that is, health services that offered medically accurate sexual and reproductive health information, as well as nonjudgmental care tailored to the evolving capacities of adolescents entering early adulthood they were extremely limited in the country. While private health lifestyle promotion centers existed, these were largely thought to be unprofitable. Fewer than 120 youth-friendly health services were available, mainly in large cities, serving less than 1% of the total population of young people aged 14-28, with inconsistent quality of care.
As a result, adolescents are at increased risk of sexually transmitted infections and HIV cases are rising in this age group. A UNFPA survey of adolescents in 2019 found that 90% of adolescents surveyed in Kazakhstan could not identify all the ways HIV can be transmitted. Contraceptive prevalence also remains low among sexually active young people.
But all this is about to change.
Charting the path of progress
In 2019, as part of an international movement to improve sexual and reproductive health for all, the government of Kazakhstan pledged to increase adolescents’ access to outpatient health services and increase funding for sexual and reproductive health services youth-friendly reproductive system.
UNFPA worked with policy makers and the ministry of health to develop a comprehensive legal framework to ensure care for adolescents and young adults, including lowering the age of consent to receive many outpatient services from 18 to 16 years. UNFPA has also helped create clinical and operational standards that meet the Quality Standards recommended by world health organizations.
Existing youth-friendly health services have been strengthened and awareness of their services has been raised within communities. Legislation then imposed such facilities in every city in the country and required these services to be covered by compulsory social health insurance.
Thousands reached in a few months
Funding is now flowing into health centres, which offer a wide range of services. “This year alone we finally received state funding, in January 2023, said Dr. Sholpan Karzhaubayeva, who heads one of the centers in Almaty. Since then, in four months, we have recorded 3,286 individual visits from gynecologists in our center. In our center, we also provide psychological consultations for our young patients.”
Seventeen-year-old Amina was among those receiving treatment. She explained that missing her period after her first sexual encounter had left her scared and unsure where to turn. But you at the center you were able to receive information and advice from doctors without stigmatization.
This type of care will soon become the norm. The Almaty center is seen as a resource facility, offering a model for the rest of the country’s 170 youth-friendly health centres, Dr Karzhaubayeva explained. We often host public lectures, conduct outreach events at universities and colleges, and build the capacity of youth-friendly health center specialists across the country.”
UNFPA has supported the training of approximately 300 physicians, psychologists and social workers, and the state has provided $35 million in funding between 2021 and 2025, a promising start for youth health services nationwide.
The centers are already making a huge difference, said Serik Tanirbergenov, an analyst with the UNFPA program on sexual and reproductive health.
In addition to funding sexual and reproductive health care and raising and standardizing the quality of service, all young people will be eligible for care, Tanirbergenov stressed.
All teenagers in Kazakhstan, whether they live in a big city or a small town, will receive the same care.
*Name changed for privacy
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