Turkey’s record on mother-child health care

“In my years as an activist, I came across young girls from Nepal who would not go to school for three days every month,” said Kazuko Fukida of Japan, speaking as part of a panel - one of several at the International Conference on Population and Development taking place since Tuesday, Nov. 12, in Kenya’s capital.

The three-day summit in Nairobi is called ICPD25, as it is organized by the United Nations Population Fund to accelerate the implementation of the commitments that were made on sexual and reproductive health 25 years ago at a conference in Cairo.

While significant progress has been registered in certain areas, like decreasing maternal deaths, one of the areas where governments have lagged is in providing comprehensive sexuality education, known by the acronym CSE.

It is one of the things several countries, including Turkey, have failed to deliver primarily because sexual education structured according to age is still considered by the ruling elites as promoting sex at an early age.

There is virtually no CSE in Turkey, not even for seniors in high school. That’s why “Güzin abla” (“abla” standing for sister) has remained a very popular column for decades at daily Hürriyet, as young women could send anonymous letters asking whether they risked pregnancy by going to a Turkish hamam (bath) after a men’s session. Today, there is sister or brother Google, where adolescents are resorting to satisfy their very natural curiosity about their bodies and sexual issues. But the internet is not the best outlet to find health information. It can be places for marketing products, especially for those adolescents or youngsters, who in the absence of education might think their body parts are not the correct sizes.

Or in cases like Turkey, the conservative Islamists could get a hold of the priority of appearing at the top, providing information that might not be correct.

Addressing social media giants like Google and Facebook to give priority to the right information was an issue underlined by UNICEF officials at the Nairobi summit, which is gathering around 6,000 delegates from governments and non-governmental organizations.

The need for CSE has become even more important for Turkey especially in view of the rise in cases of child abuse, as children, in the absence of education structured according to age, do not understand when they are subjected to abuse and ignore how to respond.

The rise of diseases, especially the increase in HIV-infected patients seen in Turkey are among the other negative consequences of a lack of education.

The summit, hosted by the Kenyan government and co-sponsored by Denmark, is providing an opportunity for countries to review where they are in terms of their commitments made 25 years ago.

A key issue where Turkey seems to have not only failed to deliver but seen a setback is in family planning.

Turkey has invested tremendously in family planning and reproductive health especially after the ‘60s, in order to slow down the high rate of maternal deaths, according to experts. Mother-child health care and family planning centers were established, providing in service training to health personnel, so that they could give counseling and medical intervention for women.

But in the course of the past two decades, while the birth rate has not dropped to alarming levels, the rise in the elderly population (10 percent according to the 2018 survey released last week) has been an issue of concern to the government, which has focused its attention on increasing the ratio of the young generation by increasing the birth ratio.

With the transition in the general health care system, mother-child health care and family planning centers were closed to be replaced with the current family health centers, where in-service training for health personnel is not sufficiently given so they can perform modern contraceptive techniques, for instance.

According to the 2018 survey, 12 percent of currently married women have the highest level of unmet need for family planning; which is defined as the percentage of married women who want to space their next birth or stop childbearing entirely but are not using contraception.

In other words; women who want to have children at a later stage or who no longer want to have a child are not using any modern method to prevent it; which means they can not get proper counseling nor services from the state. This ratio was 6 percent 5 years ago; when the same survey was conducted.

Abortions in public hospitals are only performed under certified medical conditions, and this leads women to seek illegal ways or unconventional methods that can end in death, according to experts.

“Family planning is above all about prevention; it is about saving lives, which is a fundamental mission of a state. European countries are also suffering from an aging population, but instead of resorting to bans, they increase the number of day care centers, for instance, to encourage working women to give more births,” a representative of an NGO told me.