Azerbaijan�s new sex-ed curriculum targets sex-selective abortions

Azerbaijan is rolling out a new sex-education curriculum to address high adolescent pregnancy rates and abortions among teenage girls. The program also aims to tackle sex-selective abortions; across the country, but especially in conservative rural areas, parents often prefer boys and will terminate female embryos.

The government has been developing the new curriculum for three years, and it will be the first comprehensive sex-ed curriculum in Azerbaijan"s post-Soviet period. Previous sex-ed instruction, which often focused on preventing the spread of sexually transmitted diseases, was adopted with the help of UNICEF and other international organizations but was "sporadic and not comprehensive," Dr. Nabil Seyidov, head of the Department of Health Policy and Reforms at the Health Ministry, told Eurasianet.

Abortion rates among teenage girls appear to be on the rise.

A 2013 study by the London School of Hygiene and Topical Medicine concluded that in Azerbaijan, "between 2005 and 2009 almost 10 percent of potential female births [...] did not occur because of prenatal sex selection."

And a 2014 study by the European Population Conference determined that for every 1,000 females aged 15 to 19 in Azerbaijan, there were a total of 67 pregnancies registered, placing the country only behind Bulgaria among the countries surveyed. It also noted that "abortion reporting [in Azerbaijan] is incomplete and pregnancy rates are therefore underestimated."

Abortions by teenage girls also have been on the rise: In 2017, there were 1,605 abortions among girls from 15-19 years old, compared with 1,261 the year before, according to government statistics. Among girls between ages 15-17, the increase was even greater.

The new curriculum "will decrease the number of STDs and infections, and will also prevent teenage pregnancies and abortions," Seyidov said. The program also "aims to improve the mental state of women, because these problems bring psychological effects to women, and these issues have never been addressed before."

Thus far, the program, created by the Ministry of Education and Ministry of Health, has been tested in a pilot program involving about 60,000 public school students in the seventh and ninth grades. It covers sexually transmitted disease prevention, but also educates "what girls can and should do in the occurrence of sexual assault," Seyidov said.

Trainings on for instructors of the new curriculum began in November in Baku, and will be formally introduced in all schools following the approval of the curriculum by the Ministry of Education, which is expected in early 2019, though an exact date has not been announced.

Public opinion about the proposal appears mixed. When the Azerbaijani service of Radio Free Europe/Radio Liberty did interviews on Baku"s streets to gauge public opinion, most respondents said that there was a need for better sexual education in Azerbaijan but were unsure that schools were the place to do it. One interviewee said that the "public mindset isn"t ready for this type of education." Another said, "I have a daughter, [and] only the mother can discuss [these issues] with her."

But women"s health advocates welcomed the effort. "Sex education is very much needed in Azerbaijan. This is a country with serious gaps in the area of sexual and reproductive health and rights," Shahla Ismayil, chairwoman of the Women's Association for Rational Development, a nongovernmental organization, told Eurasianet. Still, she said the success of the program will rely on its implementation by teachers who are often poorly qualified and have a "biased" attitude against sex education. "Will they truly be able to teach children sex education?"

This is not the government"s first effort to tackle sex-selective abortions. In 2013, Baku considered banning prenatal gender detection as a way to combat the practice, though ultimately no policy was changed. After abandoning that effort, the government instead looked to education as a way to change behaviors, ultimately leading to the new curriculum, Seyidov said.

Sex-selective abortions are more common in rural areas of Azerbaijan, and there the challenges are especially great. While the overall sex-ratio at birth is 115 boys to 100 girls - one of the highest rates in the world - in rural areas it is even higher. The western districts of Sheki and Ganja have ratios of 149 and 144 respectively, according to statistics from the United Nations Population Fund.

Rural women are often unwilling to take or unable to afford contraceptives if they don"t want to get pregnant. "Many women still believe that [contraceptive] hormones are something evil, that they are harmful to health, [and that] abortions are a better evil, if you have to choose between them," said obstetrician-gynecologist Elnara Huseynova in an interview with news website Echo.az. The problem can be exacerbated by unscrupulous gynecologists who treat abortions as a source of income and thus steer women toward them, Huseynova added.

"Rural communities will resist sex education more intensively," predicted Ismayil, and suggested that some parents could use it as a justification to remove girls from school, when it is already common for them to drop out at age 13 or 14. "There should be a very intense and in­-depth awareness raising and orientation with parents and rural "gatekeepers" to explain them the necessity and benefits" of the program," she added.

Austin Clayton is a writer based in Baku.