Keo-Oudom Hospital, Vientiane Province, Lao PDR. February 2024. Saly Sorsaksit and Noud Sivanxay have a golden rule.
“We decided before getting married that we would be fully ready as parents before even having kids. It is a big step, we must know when it’s best [to have children] and how to care for them and each other as parents,” said Saly, who married her sweetheart last month after a two-year courtship.
This meant the Lao couple, both 27-years-old and agriculture salespeople, was also united in its quest to seek sexual and reproductive health, family planning support before tying the knot.
For Saly and Noud, the UNFPA-supported and Grand Duchy of Luxembourg-funded “Couple’s Counselling” project proved to be the ultimate wedding present.
“We feel grateful to have had this opportunity, more couples must experience it,” said Noud.
The couple recounted their story at Keo-Oudom hospital, in Vientiane Province, that welcomed His Excellency Mr. Xavier Bettel, Minister of Foreign Affairs of the Grand Duchy of Luxembourg and a delegation of parliamentarians on an official visit to Lao PDR to see first-hand how projects like “Couples’ Counselling” are breaking new ground in women and young people’s health outcomes in this Southeast Asian country.
The project, co-created by the ministries of Health and of Home Affairs rolled out in Vientiane Province and Vientiane Capital, has worked since early 2023 to ensure couples receive the knowledge and support to make healthy choices around sexual and reproductive health, family planning, contraception and the legal importance of civil registration.
Already, more than 500 couples like Saly and Noud have been reached.
“The best investment a country can make is in its people, including in the well-being, health and empowerment of women and girls. Ensuring access to sexual and reproductive health services and rights is fundamental to achieving gender equality and laying the foundation for sustainable development. This is why Luxembourg has been a long-time supporter of strengthening health systems in Lao PDR together with UNFPA,” said His Excellency Mr. Xavier Bettel,Minister of Foreign Affairs of the Grand Duchy of Luxembourg.
The couples’ counselling project is unique in Lao PDR as health providers take friendly, non-discriminatory and confidential approaches to provide full spectrum support to ensure each couple’s wellbeing.
“This holistic and cross-sectoral approach is expected to contribute to enhancing sexual and reproductive health and realizing reproductive rights, advancing harmony, gender equity and equality, as well as increasing birth registration to leave no one behind,” said Dr. Bakhtiyor Kadyrov, UNFPA Representative to Lao PDR.
Dr. Lavanh Rattana, a 10-year health professional who helps deliver counseling sessions, also sees first-hand how these project approaches are impactful.
She said the project not only empowered couples to make informed choices about when to have children, spacing between births and contraception in step with antenatal and mother care, it also focussed on relationship wellness through conflict resolution, mutual support between wife and husband and embedded values such as respect and non-violence.
Dr. Rattana, who received UNFPA and Luxembourg-supported training on couple's counselling, contraception, mother and child health, said the project had great potential to be a game-changer in helping meet the country’ssexual and reproductive health, family planning and maternal health needs.
She said further boosting mobile outreach, telehealth and training local health providers at the village level was essential to reach remote communities and ensure no one was left behind.
In 2023, The Lao Social Indicator Survey revealed that the adolescent birth rate in Laos (number of births to women aged 15-19 years per 1,000 women in that age group) reached 89 per 1000, while women aged 20-24 who have had a live birth before the age of 18 represent 17.4%. The percentage of adolescent girls aged 15-19 currently married or in union is 26.5%.
The Grand Duchy of Luxembourg and UNFPA have already made important progress in addressing these challenges, with the “Couple’s Counselling” project one of three initiatives in the third phase (2022-2025) of a United Nations Joint Programme that started in 2011 with UNICEF and WHO.
The innovative Adolescent and Youth Friendly Services model ensures the sexual and reproductive health needs of adolescents and young people are met with empathy, confidentiality and without judgment.
The model, being implemented in six provinces across the country including Vientiane Capital, trains health providers in outreach to schools, factories, communities and delivers mental health and psycho-social support through hotlines and a mobile application to provide information and referrals to services.
The third initiative focuses on maternal health care, with the strengthening of health staff capacity to provide quality care to women during pregnancy, childbirth and post-delivery. This has resulted in a specific training programme to increase the capacity of midwives to provide ante-natal, intra-partum and post-natal care, while the Lao Association of Midwives has been strengthened to function as a professional body for the licensing and regulation of midwives.
To further improve maternal health care services, a MPDSR (maternal and perinatal death surveillance and response) initiative was launched in 2023 to avert maternal death and disability, by supporting the health system to conduct well-founded maternal death reviews and develop recommendations for practical actions. In fact, knowing the rate of maternal deaths is not enough to prevent the deaths. Knowing more about the women and their conditions, as well as, remedial and preventive factors is needed to prevent maternal deaths and lower the Maternal Mortality Rate.
This partnership between the Grand Duchy of Luxembourg and UNFPA as well as local partners and other United Nations agencies is important as reaching full coverage targets for family planning and nutrition, maternal, newborn, child and adolescent health interventions in Lao PDR by 2030 is affordable and can generate USD 6 in economic returns for every dollar invested.
The Grand Duchy of Luxembourg is a valued supporter of UNFPA’s impactful work as part of the International Conference on Population and Development, which aims to achieve zero unmet need for family planning, zero preventable maternal deaths, zero gender-based violence and harmful practices such as child marriage and adolescent pregnancy by 2030.
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UNFPA, the UN's sexual and reproductive health agency, works in over 150 countries, including Lao PDR, to achieve zero maternal deaths, zero unmet need for family planning and zero gender-based violence.
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