Over the past three or four years, the number of visits to the Counseling Center for Sexual and Reproductive Health has decreased rapidly, even though it is one of the oldest consulting centers in the country and it has been operational for seven years now within the Public Health Center in Kumanovo. The reduced number of patients is due to the fact that only social medicine doctors, rather than gynecologists, are working at the center. Because of budget cuts, approved through a project, no gynecologist has been hired at the Counseling Center for a few years now, so there are no patients, either.
“I have to admit that, when we had a gynecologist, there was much greater interest in the services that the Counseling Center renders and we had a large number of patients primarily from the Roma community, as well as high-school students who visited it regularly. Recently, this number has declined rapidly,” says Marjan Denkovski, the social medicine doctor at the Kumanovo Public Health Center.
The citizens, too, ask to see a gynecologist at the Counseling Center. A 32-year-old Kumanovo resident says that she would use the services that the Counseling Center provides, especially when it comes to sexually transmitted diseases.
“I am divorced and I have had a few partners over the past year. Although I can speak to a gynecologist, it would be good for such a counseling center to exist for those people who cannot afford going to a gynecologist, myself included, so every free-of-charge visit and professional advice would be good for us,” the Kumanovo woman says.
A mother of two teenagers has not even been informed that such a counseling center exists in the first place and explains that she would send her children, aged 16 and 14, to obtain new information about sexual or reproductive health.
“I personally am not informed enough about certain diseases because I have never needed to know such a thing, but I believe that it is excellent that such an institution exists to provide education to the young. I have to admit that no one in my family, either my husband or I myself, talk about such matters to the children,” the 44-year-old mother says.
The young people in Kumanovo are not familiar with the Counseling Center, either.
“There is no information about it anywhere. I had the last free lecture of this kind in high school. Different means for dissemination of information and promotion are needed for the young. For example, this institution can be promoted via the social media,” a 22-year-old girl says.
The respondents are asking that a gynecologist should be employed at the center and that the center should be promoted among the vulnerable criteria, such as the young and the people with a low income or no income at all.
The Counseling Center is open twice a week and it is intended for women who are at the reproductive stage, young people and people who cannot receive advise from their gynecologist for various reasons. The center is also visited by people who belong to the category of socially vulnerable categories, people who cannot afford to visit a gynecologist, patients with no health insurance, people who do not possess documents and people who have certain health issues, but refuse to speak about these with their gynecologists. The services rendered by the Counseling Center are used by the sexually active young people who wish to inform themselves about how to protect themselves of unwanted pregnancy, sexually transmitted diseases and the like.
“We promote the Counseling Center among these categories of people that is, the lower social classes, through leaflets, promotions in the districts where they live, and among the high-school students and the older students in primary schools by distributing textbook to them at the beginning of the school year and pointing to the existence of this center,” Denkovski explains.
The adults who use the services of the Counseling Center are satisfied with the doctors, but they themselves ask for a gynecologist. However, the center employees add that they do not provide classic medical examination, but only advice about whom the patients should see to solve a particular health problem. The adolescents who visit the Counseling Center, on the other hand, receive information about all the issues related to sexual and reproductive health.
“Their visits to the gynecologist enables them to become familiar with certain procedures because social and health insurance is provided during pregnancy regardless of whether or not the patient has a health insurance. People have come here without documents, so, after the NGOs have provided documents for them, they have received regular healthcare protection,” Denkovski says.
When visiting the Counseling Center, the patients do not have to bring their medical cards or IDs, but they can simply come and receive a service. Material, that is, brochures on sexual-reproductive health, sexually transmitted diseases and the like, is available to the public. A certain quantity of condoms is available, while, in the past, contraceptive pills were available, too.
The Counseling Center is at the public’s disposal, but it needs support to become fully operational for the patients. According to the relevant authorities, the center cannot receive support from the state institutions because the patients’ rights are regulated differently under the law, while the Counseling Center has been established for those persons who wish to remain anonymous for a particular reason, but still to receive certain services. The authorities are looking for funds to subsidy the appointment of a gynecologist in the team who would offer advice because the gynecologist’s presence would improve the quality of the services that the center provides to the patients. The very presence of experienced gynecologists will contribute to greater affirmation and better use of the potentials of the Counseling Center, as well as to free health assistance to the patients.