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Former USSR: Armenia Ranks Last In Contraceptive Use

Washington, 14 April 1997 (RFE/RL) -- A newly-released study on contraceptive use around the world ranks Armenia last and Ukraine as second-to-last as far as contraceptive availability in developed countries.

The study called "Contraceptive Choice: Worldwide Access to Family Planning" was released Sunday in Washington by Population Action International, a U.S.-based private, non-profit organization which supports the expansion of voluntary family planning.

The study ranks 88 developing and 39 developed countries. Eighteen countries in Central and East Europe, Russia and the nations of the former Soviet Union, participated. All were considered developed countries.

Noticeably missing from the survey are Poland, Belarus, Azerbaijan and all the former republics of Yugoslavia. Survey analysts say they were unable to procure enough cooperation from needed health authorities, experts and non-governmental agencies in these countries to rank them properly.

Six methods of contraceptive barriers in each country were rated: condoms, oral contraceptives, intrauterine devices (IUDs), injectable contraceptives, female sterilization and vasectomies -- a male sterilization process. Scores were converted to a 100-point scale, with each barrier method having a maximum of 20 points.

Armenia ranked last of the 39 developed countries surveyed with a score of 33.3. Citizens in the country were said to have fair access to condoms, IUDs, and oral contraceptives. However, the country was considered to have severely limited or no access to injectable contraceptives, female sterilization or vasectomies.

Ukraine came in second-to-last with a score of 41.7. Access to condoms, IUDs, oral contraceptives, and injectable contraceptives was considered fair. Access to the procedure of female sterilization was rated low. Like Armenia, Ukraine was said to have severely limited or no access to vasectomies.

Among the countries of Central and Eastern Europe, the Czech Republic was rated the highest with a score of 75. Availability of condoms, oral contraceptives, IUDs and injectable contraceptives was considered excellent. However, access to the procedures of female sterilization and vasectomies was rated poor, although still available.

Estonia ranked the highest among the countries of the former Soviet Union with a score of 70.8 which rated even higher than France, Japan and Portugal. Estonia was considered to have excellent availability of condoms, oral contraceptives, IUDs, and injectable contraceptives. However, Estonia was seen as having limited access to female sterilization and was one of 13 developed countries which have little or no access to vasectomies.

The study also covered the issue of abortion which for decades has been the primary method of birth control in many countries around the world, including Russia, Eastern Europe and the countries of the former Soviet Union.

The study concluded that the wider availability of contraceptives is definitely having a pronounced impact on the number of abortions in the region.

The study stated that within the past several years in Russia, Kazakhstan and Ukraine, both abortion rates and the annual number of abortions have declined very rapidly following the expansion of contraceptive services.

In regards to Russia, the authors of the study referred to data provided by the Russian Ministry of Health which showed that from the period of 1990 to 1994, contraceptive use -- primarily IUDs and birth control pills -- increased from 19 percent to 24 percent in Russia. The data indicated that during this same period, the number of abortions in Russia dropped from 3.6 million to 2.8 million.

The authors cited similar data for Kazakhstan, saying that from 1993 to 1994 -- after the United States Agency for International Development provided training for doctors and nurses and contraceptive supplies for 28 clinics in the city of Almaty -- contraceptive use in the city jumped 59 percent. During the same period, the data indicates that abortions in the city declined by 41 percent.

In Ukraine, the authors of the study pointed to a report by the Ministry of Health in which it reported a significant decrease in abortions from January to June 1996. The Ministry directly attributed the drop to the women's reproductive health program which began in 1995 with USAID funding, calculating that the abortion ratio fell 8.6 percent during this six month period.

Despite the obvious correlation between increased availability of contraceptives and a decrease in abortion, the study cautioned that abortion still remains a major method of birth control in many countries of the former Soviet Union. Part of the reason, said the study, is the uneven availability of barrier methods, especially in rural areas, and the high cost of contraceptive devices.

Overall, the study's ranking (out of 39) for the countries in Central and East Europe are: Czech Republic (17); Hungary (19); Slovakia (23); Bulgaria (27); and Romania (36).

The ranking for Russia and the countries of the former Soviet Union are: Estonia (21); Russia (24); Latvia (25); Kyrgyzstan (28); Turkmenistan (29); Uzbekistan (30); Lithuania (31); Georgia (32); Kazakhstan (33); Moldova (34); Tajikistan (37); Ukraine (38); and Armenia (39).

The United States was sixth on the list.