Additional perspectives . Participants express a distrust of public sector physicians, with many believing they are callous and incompetent. Consequently, they do not trust them to provide reliable information, although for many they are the only source. Similarly, they do not trust doctors to provide reliable service, with numerous complaints throughout the region about IUDs inserted without a patient s knowledge or consent. Participants are of two minds about abortion, expressing strong and almost unanimous objections on moral and health grounds, contrasted with widespread acceptance for practical purposes.
Many people simply see no alternative.
The strongest objections to abortion come from the more conservative Muslim areas of the region, although even in these areas some people question the morality of bearing children one cannot support, or endangering the life of the mother through too closely spaced pregnancies. Some cite Koranic injunctions against irresponsible parenthood and justify abortion in cases of extreme family hardship. In general, participants accept abortion as a necessary evil in times of deprivation and economic hardship and in the absence of reliable contraceptive supplies and services. Implications for Reproductive Health Programs in the Central Asian Republics Based on the results of each country s focus group discussions, reviewers have developed specific reproductive health program considerations which are listed in the conclusion section of each country report and can serve as a starting point for further research when developing country-specific communication programs. In addition, overarching issues and challenges from across the Region were expressed by focus group participants.