Article from earlier this summer containing an interview with Naomi Kitahara, UNFPA Representative of Mongolia. Original can be found here.
Recently, the UNFPA released both its “Breaking the silence for equality: 2017 National Study on Gender-based Violence in Mongolia” and a statement on reproductive resource availability by Naomi Kitahara, UNFPA representative, at the National Consultative Meeting on Reproductive Health and Family Planning. In the following interview, Kitahara discusses the progress of Mongolia in the areas of family planning and reproductive health, as well as the responses, challenges, and future plans of the UNFPA in regards to gender-based violence and human rights.
- How did the UN first launch its branch in Mongolia, and how do Mongolia’s programs differ in focus from other UNFPA branches?
Mongolia’s office started representation at the end of the 1990s. The UNFPA has worked in family planning worldwide since its inception in 1970s. At the moment in Mongolia we have three key programs: one is sexual reproductive health which family planning is part of, the second one is gender-based violence, and the last one is youth empowerment, youth participation.
- What is Mongolia’s approach to family planning policies?
Mongolia has done a great job in increasing the overall access to family planning services, even in remote areas. However, in more recent years, the country is increasingly emphasizing the importance of implementing a pro-natalist policy. They want to increase the population. Rightly so, because it’s a small country, the market is small, and they want the economy to grow. Sometimes it is misunderstood – not by everybody but some – that family planning doesn’t actually get along with the pro-natalist policy. But what is important is that couples and women have the choice of when to have a child, how many, and spacing between children. That is a rights-based approach, which we emphasize. The Mongolian government and our partners have been generally receptive. They understand the connections between family planning, human rights, and how that actually ties into the pro-natalist policy. It’s really that when we have children, we want to make sure they’re well-educated, healthy – and the mothers as well. With that, we have a more prosperous society. That’s what we’ve been discussing with the government. And they have actually done a pretty good job. They had a population policy approved a few years ago and some related policies, such as the family law. In 2016 they revised the domestic violence policy, youth development law, and so forth. They are really trying to set up an enabling environment to make quality choices available.
- What are some challenges to implementing these policies?
We don’t have sufficient state budget allocation to procure contraceptives yet. We have advocated to the government to make sure that there is sufficient allocation to procure contraceptives freely. At the moment there is a shortage of contraceptives in the country, and when I go to provinces especially this is very prominent. I would personally think that about 20% of the needs are met, unless people go to the market and actually purchase it. So in terms of the free provision of contraceptive methods there is a severe shortage right now.
In 2015, Mongolia was one of the only 9 countries in the entire world which achieved the minimum goal of maternal mortality reduction. We celebrated – it was a big thing. But in 2016, economic difficulties were hitting the country. There had been a state budget cut across all sectors, and also in 2016 there was a measles breakout. The tiny budget that had been allocated for the procurement of contraceptives had to be reallocated to deal with measles. The maternal mortality ratio doubled. By mid-year, the mortality ratio was tripling. Then we did the emergency procurement of contraceptives and spoke to the Ministry of Health, so the minister gave the direct order to pay close attention to maternal health issues. By the end of December, we contained it to 2x increase rather than 3x increase. But that is a clear example of how family planning can save the lives of mothers and the newborns as well. And that’s why it’s very, very important that we pay much more attention to planning.
UNFPA recently did a budget analysis of sexual reproductive health. We estimated that for every dollar spent on family planning, we are actually saving 3.2 dollars for the cost of pregnancy-related care. In annual terms it saves several million dollars. It’s the right place to invest and family planning is one of the most effective ways of allocating resources to achieve the best health outcome.
- How are women’s empowerment and reproductive health being promoted?
We are promoting what we call life skills education – soft skills apart from the school subject matters. It has components of sexual reproductive health, family planning, and gender-based violence, plus a human rights element, career planning, respecting others, human rights issues, understanding self, emotion, other people’s emotions, teamwork, leadership. Today’s younger generation in Mongolia is pretty open to feminism, and certainly more open to family planning. But that is not backed up by provision of services. Two years ago, also, a limited decision was made to remove standardized health education in secondary school. The idea was to have health education mainstreamed into other subjects. We argued, how do you do that? They were basically saying, “there’s a component in history about health education, in English there’s a bit…” We were not sure how it would have happened. We need to have health education as a standalone item in secondary school.
Very recently, 3-4 months ago, the government reversed that decision. Three years have passed since its removal and we are seeing the negative consequences of that decision. The youth birth rate is going up. Ignorance of HIV and STIs is going up. STIs, going up. When I travel around the provinces in Mongolia also, I hear a lot of things like halting education from teen pregnancies. But now that the government reversed that decision, in the very near future we will hopefully see improvement.
- How are the concepts of toxic masculinity and feminism received?
We still get backlash when we talk about toxic masculinity and women’s empowerment and so forth, but it’s the process. I’ve been here for five years in Mongolia, and even in this short time, I can see big progress in gender equality. When I arrived and when we talked about gender-based violence, nobody would have even listened. But in the past years, they have really started talking about it and our gender-based violence progress report was received very well. Surprisingly, we didn’t get strong criticism from this. Society is not only changing, but changing in the right direction – towards equality.
- What are your future projects or current plans?
Since we just released the prevalence survey report, we are discussing in-depth analysis with national partners. Of course independent researchers can take it up too – it doesn’t always have to be us. The government can do its own analysis as well. We’re also doing the economic assessment of the cost of violence. We really want the government to allocate a budget for domestic violence and gender-based violence issues. They’ve improved the DV law in December 2016 – which is very good – but it needs to be funded. In order for them to do so we also need to provide the evidence, to tell them how much GBV is costing the country. Often, victims cannot work, have health problems for which they need to be treated – there is an economic cost. We’ve just done an analysis on the current level of budget allocated for GBV. That report should be released soon. We’ll have the current level, we provided the prevalence – which took into account the level of underreporting as well – then, once we do the economic cost of violence, we should be able to tell exactly how much they need to allocate.
- What kinds of resources are available for victims and how can they be improved?
What we have piloted in the past years is what we call one-stop service centers for victims of violence. Victims can go into one place and receive many services. Physical and psychological care are provided. So are police protection and legal services if one wants to initiate a divorce or legal action. Before we piloted that, services were not readily available or efficiently accessible, which led to revictimization. I’m already in a very difficult situation if I am a victim of violence – physically and mentally. But if I have to go to many different places to look for help, it’s impossible. So we piloted one-stop service centers. We have 6 of them. We’re expanding to 10 more. We actually want to pilot services for men. Often, male perpetrators know something is wrong. But they don’t know where to go and services are not available for them. That’s in our plan. We want to do it a bit more carefully though. Some people may ask “Why are you serving men? Those are the wrong people.” But actually, we assess that they also require services.