Fertility Regulation in Kazakhstan : The Role of Providers and the Public Financial Cost

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dc.creatorRani, Manju
dc.creatorChao, Shiyan
dc.creatorArystanova, Gulzada
dc.creatorRakhimova, Meruert
dc.date2013-05-29T18:56:09Z
dc.date2013-05-29T18:56:09Z
dc.date2006-11
dc.date.accessioned2026-07-01T01:22:41Z
dc.descriptionThis study examines fertility regulation in Kazakhstan, with dual emphases on providers' attitudes toward abortion and the public financial costs of abortion provision. Though abortion incidence declined sharply in the 1990s in Eastern European countries and in the former Soviet republics, it stagnated at relatively high levels in the early 2000s, accounting for a substantial proportion of gynecological morbidity and maternal mortality. Limited literature is available on the role of health service providers' attitudes that may encourage or discourage abortion culture. Additionally, most studies examine abortion incidence from the perspective of its impact on women's health, while the issue of the public financial burden imposed by the provision of services for "avoidable" abortions remains unexplored. This study sheds lights on these two areas by conducting a two-part field survey in Kazakhstan. Three-stage stratified sampling was used to select 126 providers from 52 health facilities from four oblasts and two major cities (Almaty and Astana) at different administrative levels to assess providers' attitudes and perceptions; and to analyze the public costs of providing abortion and family planning services. Findings from the provider survey suggest that providers' biases towards certain contraceptive methods-partly attributable to their lack of training in alternative methods-lead them to limit the choice of contraceptive methods on offer, thereby reducing the quality of family planning services and potentially contributing to stagnating abortion rates. Findings from the costing survey suggest that in terms of cost per birth averted, contraceptives are almost 3.2 times more cost-effective than abortion services. In 2004, abortion services accounted for almost one percent of total public health spending. The study suggests that by expanding family planning services, including increasing contraceptive choices, the reliance on abortion for fertility control may be reduced. Savings may be redirected to improved family planning services or other public health interventions.
dc.formatapplication/pdf
dc.formattext/plain
dc.identifierhttp://documents.worldbank.org/curated/en/2006/11/7405560/fertility-regulation-kazakhstan-role-providers-public-financial-cost
dc.identifierhttps://hdl.handle.net/10986/13650
dc.identifierhttps://doi.org/10.1596/13650
dc.identifier.urihttp://hdl.handle.net/123456789/417540
dc.languageEnglish
dc.languageen_US
dc.publisherWorld Bank, Washington, DC
dc.relationHNP discussion paper series;
dc.rightsCC BY 3.0 IGO
dc.rightshttp://creativecommons.org/licenses/by/3.0/igo/
dc.rightsWorld Bank
dc.subjectABORTION
dc.subjectABORTION COMPLICATIONS
dc.subjectABORTION RATE
dc.subjectABORTION RATES
dc.subjectABORTION SERVICES
dc.subjectAFTER ABORTION
dc.subjectANALGESICS
dc.subjectANESTHESIA
dc.subjectANTIBIOTICS
dc.subjectBLOOD PRODUCTS
dc.subjectCHILD-BEARING
dc.subjectCHILDREN PER WOMAN
dc.subjectCLINICS
dc.subjectCONCEPTION
dc.subjectCONDOM
dc.subjectCONDOMS
dc.subjectCONTRACEPTION
dc.subjectCONTRACEPTION USE
dc.subjectCONTRACEPTIVE CHOICE
dc.subjectCONTRACEPTIVE CHOICES
dc.subjectCONTRACEPTIVE METHOD
dc.subjectCONTRACEPTIVE METHODS
dc.subjectCONTRACEPTIVE PREVALENCE
dc.subjectCONTRACEPTIVE PREVALENCE RATES
dc.subjectCONTRACEPTIVE SERVICES
dc.subjectCONTRACEPTIVE SUPPLIES
dc.subjectCONTRACEPTIVE USE
dc.subjectCONTRACEPTIVES
dc.subjectDECLINE IN FERTILITY
dc.subjectDECLINES IN FERTILITY
dc.subjectDEVELOPING COUNTRIES
dc.subjectDRUGS
dc.subjectECTOPIC PREGNANCY
dc.subjectEFFECTIVE CONTRACEPTIVE
dc.subjectEFFECTIVE FAMILY PLANNING
dc.subjectEMERGENCY FACILITIES
dc.subjectFAMILY PLANNING
dc.subjectFAMILY PLANNING METHODS
dc.subjectFAMILY PLANNING PROGRAM
dc.subjectFAMILY PLANNING SERVICES
dc.subjectFAMILY SIZE
dc.subjectFEMALE STERILIZATION
dc.subjectFERTILITY
dc.subjectFERTILITY CONTROL
dc.subjectFERTILITY LEVELS
dc.subjectFERTILITY RATE
dc.subjectFERTILITY RATES
dc.subjectFERTILITY REGULATION
dc.subjectGROSS NATIONAL INCOME
dc.subjectGYNECOLOGIST
dc.subjectGYNECOLOGISTS
dc.subjectGYNECOLOGY
dc.subjectHEALTH
dc.subjectHEALTH CARE
dc.subjectHEALTH CARE SYSTEMS
dc.subjectHEALTH FACILITIES
dc.subjectHEALTH FACILITY
dc.subjectHEALTH INTERVENTIONS
dc.subjectHEALTH PROBLEMS
dc.subjectHEALTH PROVIDERS
dc.subjectHOSPITAL
dc.subjectHUMAN DEVELOPMENT
dc.subjectHYPERTENSION
dc.subjectINDUCED ABORTION
dc.subjectINTERVENTION
dc.subjectISSUE OF ABORTION
dc.subjectIUD
dc.subjectIUDS
dc.subjectLACK OF INFORMATION
dc.subjectLOWER FERTILITY
dc.subjectMATERNAL DEATHS
dc.subjectMATERNAL MORTALITY
dc.subjectMEDICAL FACILITIES
dc.subjectMEDICAL PERSONNEL
dc.subjectMIDWIFE
dc.subjectMIDWIVES
dc.subjectMINISTRY OF HEALTH
dc.subjectMODERN CONTRACEPTIVE METHODS
dc.subjectMODERN CONTRACEPTIVES
dc.subjectMODERN METHODS OF CONTRACEPTION
dc.subjectMORBIDITY
dc.subjectNATIONAL HEALTH
dc.subjectNATIONAL LEVEL
dc.subjectNUMBER OF ABORTIONS
dc.subjectNUMBER OF BIRTHS
dc.subjectNUMBER OF WOMEN
dc.subjectNURSE
dc.subjectNURSES
dc.subjectNUTRITION
dc.subjectORAL CONTRACEPTIVE
dc.subjectORAL CONTRACEPTIVES
dc.subjectPATIENTS
dc.subjectPERIODIC ABSTINENCE
dc.subjectPHYSICIANS
dc.subjectPILL
dc.subjectPILLS
dc.subjectPOLICY MAKERS
dc.subjectPOPULATION DIVISION
dc.subjectPOPULATION POLICY
dc.subjectPOPULATION POLICY DATA
dc.subjectPOST-ABORTION
dc.subjectPOST-ABORTION CONTRACEPTIVE
dc.subjectPOST-ABORTION COUNSELING
dc.subjectPOSTABORTION
dc.subjectPREVENTION OF INFECTION
dc.subjectPRIMARY HEALTH CARE
dc.subjectPRIMARY HEALTH CARE FACILITIES
dc.subjectPROVISION OF SERVICES
dc.subjectPUBLIC HEALTH
dc.subjectRELIANCE ON ABORTION
dc.subjectREPRODUCTION
dc.subjectREPRODUCTIVE HEALTH
dc.subjectRURAL DISTRICT
dc.subjectSERVICE PROVIDERS
dc.subjectSOCIAL AFFAIRS
dc.subjectSPERMICIDES
dc.subjectSTATE POLICIES
dc.subjectTERTIARY LEVEL
dc.subjectTOTAL FERTILITY RATE
dc.subjectTREATMENT OF COMPLICATIONS
dc.subjectUNFPA
dc.subjectUNITED NATIONS POPULATION FUND
dc.subjectUNMARRIED YOUNG MEN
dc.subjectUNWANTED PREGNANCY
dc.subjectURBAN AREAS
dc.subjectUSE OF FAMILY PLANNING
dc.subjectUSE OF FAMILY PLANNING METHODS
dc.subjectVICIOUS CYCLE
dc.subjectWASTE
dc.subjectWOMAN
dc.subjectWOMEN OF CHILD-BEARING AGE
dc.subjectYOUNG MEN
dc.titleFertility Regulation in Kazakhstan : The Role of Providers and the Public Financial Cost

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