KUALA LUMPUR, Oct 25 — The Women, Family and Community Development Ministry has confirmed that single women are only prescribed birth control at its clinics if they agree to “counselling”, a policy it insists is aimed at discouraging “random sex”.
Contacted over claims that public sexual healthcare providers were biased against unwed women, Dr Komathy Thiagarajan, who heads the Clinical Unit at the Human Reproduction Division under the ministry’s National Population and Family Development Board (LPPKN), said the national family planning policy was initially drafted with the purpose of reducing the “Total Fertility Rate” (TFR) among married couples.
But with a currently low TFR, she said the focus on family planning was now to reduce the “unmet needs” including that of single women.
“So, based on the existing policy, the family planning service to unmarried women is not prohibited.
“However, those women have to go through counselling to ensure they are using family planning only to avoid unplanned pregnancies and not as an easy excuse to practise random sex,” she said in an e-mail interview.
Checks by Malay Mail Online at one Nur Sejahtera clinic run by the LPPKN showed that the revised directive did not appear, however, to have reached the staff treating the public.
Nurses manning the registration insisted only married women may sign up to get their services while Malay Mail Online’s attempt to obtain the “counselling” for single women, which Dr Komathy mentioned, was unsuccessful.
The women’s ministry through its board runs 59 Nur Sejahtera family planning clinics throughout the country. Fees charged at these clinics are generally higher than at the Health Ministry-run maternal and child health clinics.
These clinics are not regulated by the Health Ministry and are run independently by the LPPKN.
Malay Mail Online today reported of apparent bias against single women at government-run sexual healthcare providers, the majority of which insisted that unwed women may not register and obtain their services.
One clinic that said single women may obtain sexual health treatment such as access to contraceptives had added that this did not apply to Muslims, whom they claimed could only sign up with proof of marriage.
The unofficial barriers to single women securing contraceptives from public healthcare providers also come at a time when cases of teen pregnancies and baby dumping are on the rise.
Health Director-General Datuk Dr Noor Hisham Abdullah said his ministry did not have directives to discriminate against unmarried women as its policy was to provide services to all regardless of age, sex, marital status, socio-cultural, religious values or political inclination.
However, he conceded that there is variation in practice among primary health care providers “as issues surrounding unmarried sexually active women are sensitive and complex”.
He said regular training on provision of contraceptive services, counselling skills, engaging young people are conducted at all levels to empower healthcare providers to engage and manage teenagers and women in a “friendly, non-judgmental manner”.
“Continuous training is a strategy to sensitise health care personnel with regards to the stigma surrounding this issue and guide them on how best to manage such requests.
“However it may still be difficult for unmarried women to get this service in some areas due to our social, cultural and religious belief despite the training and supervision,” he said.
Women who are turned away from government facilities such as its maternal and child health clinics may lodge a complaint with the ministry, he added
Noor Hisham said that in 2012, the ministry developed a national guideline on managing sexual reproductive health problems among adolescents for primary health care providers, which focuses on management of teenage pregnancy, request for abortion, and management of sexually transmitted infection (STI), HIV, or sexual abuse as well as contraception services.
The guideline is to “strengthen the delivery of sexual reproductive health services” to not only adolescents but also adult women, which takes into consideration the “legal, ethical, rights, socio-cultural and religious perspectives”.
Noor Hisham pointed out that in the past four years, an average of about 18,000 new antenatal cases among adolescents were followed up in government clinics nationwide, of which 25 per cent involve unmarried women.
These statistics, he pointed out, denote the “acceptance of our clients to government clinic services”.