Family Planning in Asia and the Pacific - International Council on ...

previously mentioned is based on forecast needs. NPFDBrarely experiences a shortage of contraceptive suppliesas purchases are made from reliable <strong>and</strong> establishedsuppliers.While <strong>the</strong> M<strong>in</strong>istry <strong>and</strong> NPFDB may not experiencea shortage <strong>in</strong> terms of supply (as <strong>the</strong>se are undergovernment allocation), FRHAM may encounterdifficulties <strong>in</strong> susta<strong>in</strong><strong>in</strong>g supplies, as <strong>the</strong> <strong>International</strong>Planned Parenthood Federation (IPPF), <strong>the</strong> ma<strong>in</strong> sourceof fund<strong>in</strong>g for contraceptives for FRHAM, <strong>in</strong> 2010 startedimpos<strong>in</strong>g a gradual decrease of 30 per cent each year <strong>in</strong> itsfund<strong>in</strong>g for <strong>the</strong> purchase of contraceptives.Special target groups <strong>and</strong>l<strong>in</strong>kages with o<strong>the</strong>r reproductivehealth programmesYouthsThe national programme does not provide contraceptiveservices to <strong>the</strong> un-married. With ris<strong>in</strong>g marriage <strong>and</strong> <strong>the</strong>out-migration of young people to cities, adolescent fertilityhas become a major concern <strong>in</strong> Malaysia ow<strong>in</strong>g to <strong>the</strong>mount<strong>in</strong>g problems of youth sexuality, teenage pregnancy<strong>and</strong> ab<strong>and</strong>oned babies. These problems arise largely as aresult of <strong>the</strong> lack of reproductive health knowledge amongyoung people.The 2004 Malaysian Population <strong>and</strong> <strong>Family</strong> Survey showsthat a little less than half <strong>the</strong> young people aged 13-24had heard of at least one family plann<strong>in</strong>g method, <strong>and</strong><strong>the</strong> response to <strong>the</strong> question about methods varied from26.9 per cent among those younger than 15 years of ageto about 60 per cent among those aged 20-24. A higherproportion of young females than males had heard offamily plann<strong>in</strong>g methods. The lowest proportion of thosewho had heard of family plann<strong>in</strong>g methods among <strong>the</strong>ethnic groups comprised young Indians. The proportionof young people who had knowledge of family plann<strong>in</strong>gmethods was significantly higher <strong>in</strong> urban areas comparedwith rural areas.The pill was <strong>the</strong> most commonly cited method, followedby condoms. Despite <strong>the</strong> availability of condoms <strong>in</strong>pharmacies <strong>and</strong> provision shops, only one <strong>in</strong> four youngpeople had heard about this method. The rhythm methodwas mentioned by a mere 2 per cent of <strong>the</strong> young people <strong>in</strong><strong>the</strong> survey (see Table 14).Between 2005 <strong>and</strong> 2007, <strong>the</strong> adolescent fertility rates forMalaysia did not change much. The age-specific fertilityrate for those aged 15-19 years decl<strong>in</strong>ed slightly from 13.8per 1,000 women <strong>in</strong> 2004, 13.5 <strong>in</strong> 2005, 13.1 <strong>in</strong> 2006 <strong>and</strong>12.8 <strong>in</strong> 2007.To address social issues among youth with regard topremarital sexual <strong>in</strong>tercourse, ab<strong>and</strong>oned babies, unwantedpregnancies <strong>and</strong> HIV/AIDS, <strong>the</strong> government developedvarious programmes for youth, such as <strong>the</strong> kafe@TEENprogramme <strong>and</strong> PROSTAR (Programme for YouthLiv<strong>in</strong>g without AIDS). In <strong>the</strong> kafe@TEEN programme,dissem<strong>in</strong>ation of reproductive health <strong>in</strong>formation,provid<strong>in</strong>g necessary assertive <strong>and</strong> protective skills, isemphasized; kafe@TEEN centres also provide cl<strong>in</strong>icalservices, counsell<strong>in</strong>g services <strong>and</strong> recreational activities.Teen educators who run <strong>the</strong> centres also visit schools,higher learn<strong>in</strong>g centres <strong>and</strong> communities for outreachprogramme. NPFDB is plann<strong>in</strong>g to exp<strong>and</strong> <strong>the</strong> kafe@TEEN programme throughout <strong>the</strong> country by build<strong>in</strong>gone kafe@TEEN youth centre <strong>in</strong> each state.IEC programmes are be<strong>in</strong>g developed for adolescentswhere education materials <strong>and</strong> modules are used forskills development <strong>and</strong> preventive measures to deal withreproductive health issues. Two modules have beendeveloped to empower adolescents with regard to <strong>the</strong>irreproductive health knowledge <strong>and</strong> “soft skills”, such asassess<strong>in</strong>g risk <strong>and</strong> h<strong>and</strong>l<strong>in</strong>g negative peer pressure. Thesemodules provide a holistic approach <strong>and</strong> are molded to suitMalaysian societal values, cultures <strong>and</strong> religious aspects.One of <strong>the</strong> modules, “I Am <strong>in</strong> Control”, was developedunder a UNFPA project with special focus on reproductiveheath. The o<strong>the</strong>r module, “Kesejahteraan Hidup” (Wellness<strong>in</strong> Life), <strong>in</strong>cludes o<strong>the</strong>r components, namely gender, family<strong>and</strong> liv<strong>in</strong>g without violence.Concurrently, youth portals were developed for provid<strong>in</strong>geasy access to reproductive health knowledge through<strong>the</strong> Internet. Two such portals are portal kafe@TEENdeveloped by NPFDB <strong>and</strong> <strong>the</strong> My Health portal developedby <strong>the</strong> M<strong>in</strong>istry of Health.FRHAM as <strong>the</strong> key NGO <strong>in</strong> <strong>the</strong> field of RH/FP hasdeveloped several tra<strong>in</strong><strong>in</strong>g modules for young people.The “Reproductive Health Adolescent Module” has beenutilized by <strong>the</strong> M<strong>in</strong>istry of Education <strong>and</strong> some schools,while <strong>the</strong> “Perjalanan Kehidupan” (Life’s Journey), which<strong>in</strong>corporates more elements on HIV, is be<strong>in</strong>g used for<strong>in</strong>terventions at juvenile homes throughout <strong>the</strong> country.There are youth-friendly centres/cl<strong>in</strong>ics <strong>in</strong> 11 FRHAMcl<strong>in</strong>ics where <strong>in</strong>formation, para-counsell<strong>in</strong>g, sexual <strong>and</strong>reproductive health <strong>and</strong> rights education <strong>and</strong> services areavailable to young people. Cl<strong>in</strong>ical <strong>and</strong> referral services arealso provided where appropriate.Women at <strong>the</strong> end of reproductionCurrently no special programme targets women aged40-49, i.e., those who are at <strong>the</strong> end of <strong>the</strong>ir reproductivelife. In view of <strong>the</strong> high unmet need for contraceptionamong <strong>the</strong>se “older women”, as shown <strong>in</strong> Tables 4 <strong>and</strong> 5,<strong>the</strong>se women need special attention to prevent unwanted254