POPULATION AND BIRTH CONTROL ISSUES IN UZBEKISTAN

POPULATION OF UZBEKISTAN

Uzbekistan has a population of about 30 million people, making it the third most populous former Soviet republic (after Russia and the Ukraine) and the most populous country in Central Asia, which has about 67 million people. Kazakhstan is six times larger than Uzbekistan area-wise but has only has about two thirds the number of people. Most of Uzbekistan’s population is concentrated around the Syr Darya, Amu Darya and Zervashan rivers, the oases of Tashkent, Bukhara and Samarkand and the Fergana Valley.

Population: 29,199,942 (July 2015 est.), country comparison to the world: 45. Uzbekistanis make up 45 percent of the population of Central Asia. The proportion of Uzbeks is nearly the same but a little less as they make up 80 percent of the population of Uzbekistan but also are relatively large minorities in other Central Asia countries, particularly Kyrgyzstan and Tajikistan.

Median age: total: 27.1 years; male: 26.6 years; female: 27.7 years (2014 est.) Population pyramid: Dependency ratios: total dependency ratio: 48.3 percent; youth dependency ratio: 42 percent; elderly dependency ratio: 6.3 percent; potential support ratio: 15.8 percent (2014 est.). [Source: CIA World Factbook =]

Age structure: 0-14 years: 24.56 percent (male 3,676,029/female 3,496,916); 15-24 years: 19.92 percent (male 2,945,837/female 2,869,483); 25-54 years: 43.46 percent (male 6,310,206/female 6,379,037); 55-64 years: 7.17 percent (male 987,930/female 1,104,347); 65 years and over: 4.9 percent (male 610,272/female 819,885) (2015 est.) =

According to Azimov, Mutalova, Huseynov, Tsoyi, Rechel: “Although the population structure is still young, with 28.2 percent of the population aged 0–14 years in 2013, this share has been steadily decreasing since 1980. According to national statistics, based on recent changes in calculation procedures by the State Committee on Statistics, the share of the population living in urban areas was 51.2 percent in 2012. This is a much higher share than that estimated by the World Bank, which is based on World Bank population estimates and urban ratios from the United Nations World Urbanization Prospects (Table 1.1). [Source: “Uzbekistan: Health System Review” by Azimov, Mutalova, Huseynov, Tsoyi, Rechel, Health Systems in Transition, 2014 ^=^]

Population Growth and Density in Uzbekistan

For the most part Uzbekistan is sparsely populated but the population density in areas such as the fertile Fergana Valley are among the highest in the world. Population growth rate: 0.93 percent (2015 est.)m country comparison to the world: 125. Birth rate:17 births/1,000 population (2015 est.), country comparison to the world: 109. Death rate: 5.3 deaths/1,000 population (2015 est.), country comparison to the world: 180. Net migration rate: -2.37 migrant(s)/1,000 population (2015 est.), country comparison to the world: 173. [Source: CIA World Factbook =]

Sex ratio: at birth: 1.06 male(s)/female: 0-14 years: 1.05 male(s)/female; 15-24 years: 1.03 male(s)/female; 25-54 years: 0.99 male(s)/female; 55-64 years: 0.89 male(s)/female; 65 years and over: 0.74 male(s)/female; total population: 0.99 male(s)/female (2015 est.). =

In 2006, he annual growth rate was 1.67 percent, and overall population density was 64.2 people per square kilometer. Population density varies greatly, as the Fergana Valley includes most of Uzbekistan’s population centers. In the early 2000s, the greatest population growth has occurred in rural areas, and emigration has occurred mainly from urban areas. In 2006 some 63 percent of the population was classified as rural. In 2006 the net migration rate was –1.5 people per 1,000 population. [Source: Library of Congress February 2007 **]

History of Population Growth in Uzbekistan

Average number of children per woman in the 1980s was 4.4. It was not unusual for women to have eight or nine children. The rate has declined somewhat since independence due to the dropping of subsidies. There was a high rate of growth in the Soviet era because birthrate was high and the migration rate was low. 1) The population expanded by 28 percent from 6.3 million to 8.1 million from 1939 to1959; 2) expanded 90 percent to 15 million from 1959 to 1979; 3) and expanded 65 percent from 1979 to 24 million in 1999.

The growth of Uzbekistan's population was in some part due to in-migration from other parts of the former Soviet Union. Several waves of Russian and Slavic in-migrants arrived at various times in response to the industrialization of Uzbekistan in the early part of the Soviet period, following the evacuations of European Russia during World War II, and in the late 1960s to help reconstruct Tashkent after the 1966 earthquake. At various other times, non-Uzbeks arrived simply to take advantage of opportunities they perceived in Central Asia. [Source: Library of Congress, March 1996 *]

Recently, however, Uzbekistan has begun to witness a net emigration of its European population. This is especially true of Russians, who have faced increased discrimination and uncertainty since 1991 and seek a more secure environment in Russia. Because most of Uzbekistan's population growth has been attributable to high rates of natural increase, the emigration of Europeans is expected to have little impact on the overall size and demographic structure of Uzbekistan's population. Demographers project that the population, currently growing at about 2.5 percent per year, will increase by 500,000 to 600,000 annually between the mid-1990s and the year 2010. Thus, by the year 2005 at least 30 million people will live in Uzbekistan. *

Demography of Uzbekistan

In 2006 some 32.9 percent of the population was 14 years of age or younger, and 4.8 percent of the population was 65 years of age or older. The sex ratio was 0.98 males per female. In 2006 the birthrate was estimated at 26.4 births per 1,000 population, and the death rate at 7.84 per 1,000 population. Infant mortality was 70 deaths per 1,000 live births. Overall life expectancy was 64.6 years: 61.2 years for males and 68.1 years for females. The fertility rate was 2.91 children per woman. [Source: Library of Congress February 2007 **]

In the 1990s, the population of Uzbekistan was growing at a rapid rate and was split by ethnic and regional differences. The Russian component of the population shrank steadily in the years after independence. [Source: Library of Congress, March 1996 *]

Relative to the former Soviet Union as a whole, Uzbekistan is still largely rural: roughly 60 percent of Uzbekistan's population lives in rural areas. The capital city is Tashkent, whose 1990 population was estimated at about 2.1 million people. Other major cities are Samarkand (population 366,000), Namangan (308,000), Andijon (293,000), Bukhara (224,000), Fergana (200,000), and Quqon (182,000). *

The population of Uzbekistan is exceedingly young. In the early 1990s, about half the population was under nineteen years of age. Experts expected this demographic trend to continue for some time because Uzbekistan's population growth rate has been quite high for the past century: on the eve of the collapse of the Soviet Union, only Tajikistan had a higher growth rate among the Soviet republics. Between 1897 and 1991, the population of the region that is now Uzbekistan more than quintupled, while the population of the entire territory of the former Soviet Union had not quite doubled. In 1991 the natural rate of population increase (the birth rate minus the death rate) in Uzbekistan was 28.3 per 1,000--more than four times that of the Soviet Union as a whole, and an increase from ten years earlier. *

Population Patterns of Karakalpakstan Reflect Patterns in Uzbekistan

Population characteristics that have affected all of Uzbekistan have been especially pronounced in the Autonomous Republic of Karakalpakstan (the Uzbek form for which is Qoroqalpoghiston Respublikasi), Uzbekistan's westernmost region. In 1936, as part of Stalin's nationality policy, the Karakalpaks (a Turkic Muslim group whose name literally means "black hat") were given their own territory in western Uzbekistan, which was declared an autonomous Soviet socialist republic to define its ethnic differences while maintaining it within the republic of Uzbekistan. In 1992 Karakalpakstan received republic status within independent Uzbekistan. Since that time, the central government in Tashkent has maintained pressure and tight economic ties that have kept the republic from exerting full independence. [Source: Library of Congress, March 1996 *]

In the 1990s, the population of Karakalpakstan was about 1.3 million people who live on a territory of roughly 168,000 square kilometers. Located in the fertile lower reaches of the Amu Darya where the river empties into the Aral Sea, Karakalpakstan has a long history of irrigation agriculture. Currently, however, the shrinking of the Aral Sea has made Karakalpakstan one of the poorest and most environmentally devastated parts of Uzbekistan, if not the entire former Soviet Union.

Because the population of that region is much younger than the national average (according to the 1989 census, nearly three-quarters of the population was younger than twenty-nine years), the rate of population growth is quite high. In 1991 the rate of natural growth in Karakalpakstan was reportedly more than thirty births per 1,000 and slightly higher in the republic's rural areas. Karakalpakstan is also more rural than Uzbekistan as a whole, with some of its administrative regions (rayony ; sing., rayon ) having only villages and no urban centers--an unusual situation in a former Soviet republic.

Population Pressures in Uzbekistan

Population pressures have put pressures on Uzbekistan’s limited resources. In the 1990s, high growth rates were expected to give rise to increasingly sharp population pressures that would exceed those experienced by most other former Soviet republics. Indeed, five of the eight most densely populated provinces of the former Soviet Union — Andijon, Fergana, Tashkent, Namangan, and Khorazm— were located in Uzbekistan, and populations continue to grow rapidly in all five.

In 1993 the average population density of Uzbekistan was about 48.5 inhabitants per square kilometer, compared with a ratio of fewer than six inhabitants per square kilometer in neighboring Kazakhstan. The distribution of arable land in 1989 was estimated at only 0.15 hectares per person. In the early 1990s, Uzbekistan's population growth had an increasingly negative impact on the environment, on the economy, and on the potential for increased ethnic tension.

Mansur Mirovalev of Associated Press wrote: “Rights groups say the government is dealing with poverty, unemployment and severe economic and environmental problems that have triggered an exodus of Uzbek labor migrants to Russia and other countries. Heightening the government's fears is the specter of legions of jobless men in predominantly Muslim Uzbekistan succumbing to the lure of Islamic radical groups with ties to Afghan Taliban and al-Qaida. [Source: Mansur Mirovalev, Associated Press, July 17, 2010]

Fertility in Uzbekistan

Total fertility rate: 1.79 children born/woman (2015 est.), country comparison to the world: 154. In 1991 the average fertility rate was 4.1 children per woman, but about 200,000 of the women in the childbearing age range have ten or more children.

The Soviet’s initiated a rudimentary family planning program but ran into fierce resistance by the local people. Tradition plays a strong role in this male-dominated society, where a large family is seen as a blessing from God, and women are often blamed for childless marriages. There were reports in the 1990s that many women were more concerned about gaining access to contraception than about Islam.

Mansur Mirovalev of Associated Press wrote: “Uzbekistan once had one of the Soviet Union's highest birthrates, four to five children per woman, and Communist authorities even handed out medals to "heroine" mothers of six or more. Young army conscripts from Uzbekistan and the four other Central Asian republics made up for a declining ethnic Russian population. Now, as authorities try to unravel that legacy, the birthrate has dropped to about 2.3 children per woman — still higher than the rate of 2.1 that demographers consider sufficient to replenish a falling population. [Source: Mansur Mirovalev, Associated Press, July 17, 2010]

Birth Control in Uzbekistan

Contraceptive prevalence rate: 64.9 percent (2006). In the early 1990s, only an estimated 30 percent of women in Uzbekistan practiced contraception of any kind. The most frequently used method was the intrauterine device, distribution of which began in a government program introduced in 1991.[Source: CIA World Factbook, Library of Congress, March 1996]

Mansur Mirovalev of Associated Press wrote: ““Family planning is far different from Western norms. Instead of focusing on raising awareness of widely available condoms or birth-control pills, the Health Ministry has chosen to promote uteral resections nationwide as the most reliable method of contraception. Some women do volunteer. Khalida Alimova, 31, a plump, vivacious sales manager from Tashkent, agreed to a resection in March, almost a year after her third child was born. She said her husband, Alisher Alimov, 32, an occasional cab driver who spends days playing backgammon with his friends, refused to use condoms or allow her to take birth-control pills. "Now I feel relieved," Alimova said over a cup of green tea in the kitchen of their shabbily furnished Tashkent apartment. She added, though, that she never told her husband about the operation.” [Source: Mansur Mirovalev, Associated Press, July 17, 2010]

According to the U.S. Department of State: “Couples and individuals generally had the right decide freely and responsibly the number, spacing, and timing of their children and to have the information and the right to attain the highest standard of reproductive health, free from discrimination, coercion, and violence. There continued, however, to be periodic media reports that the government directed doctors to sterilize women to control the birth rate and skew infant mortality data. Contacts in the human rights and health care communities confirmed there was anecdotal evidence suggesting that sterilizations without informed consent occurred, although it was unclear whether the practice was widespread and whether senior government officials directed it. [Source: “Country Reports on Human Rights Practices for 2014: Uzbekistan ,” Bureau of Democracy, Human Rights and Labor, U.S. Department of State \*\]

Contraception generally was available to men and women. In most districts maternity clinics were available and staffed by fully trained doctors, who gave a wide range of prenatal and postpartum care. There were reports that more women in rural areas than in urban areas chose to give birth at home without the presence of skilled medical attendants.

Forced Sterilizations in Uzbekistan

According to Human Rights Watch: “In 2014, Human Rights Watch interviewed gynecologists from Uzbekistan who reported that the Ministry of Health orders some doctors to perform a certain number of forced sterilizations each month. Some women who have given birth to two or more children have been targeted for involuntary sterilization, especially in rural areas. Gynecologists confirmed that surgical sterilizations are performed without women’s informed consent and in unsafe medical facilities. [Source: “World Report 2015: Uzbekistan” Human Rights Watch]

Mansur Mirovalev of Associated Press wrote: “Saodat Rakhimbayeva says she wishes she had died with her newborn baby. The 24-year-old housewife had a cesarean section in March and gave birth to Ibrohim, a premature boy who died three days later. Then came a further devastating blow: She learned that the surgeon had removed part of her uterus during the operation, making her sterile. The doctor told her the hysterectomy was necessary to remove a potentially cancerous cyst, while she believes he sterilized her as part of a state campaign to reduce birthrates. "He never asked for my approval, never ran any checks, just mutilated me as if I were a mute animal," the pale and fragile Rakhimbayeva said through tears while sitting at a fly-infested cafe in this central Uzbek city. "I should have just died with Ibrohim." [Source: Mansur Mirovalev, Associated Press, July 17, 2010 <^>]

“After checking out of the maternity hospital in Gulistan where she lost her son, Rakhimbayeva said she shared her anguish with her husband, Ulmas, a 29-year-old bus driver. Their marriage was arranged by their parents in 2008. Instead of consoling her, she said, he told her to move back to her parents' house and wait for divorce papers as he did not want to live with a barren wife. "He never even questioned why the doctors maimed me, just blamed everything on me," Rakhimbayeva said wringing her hands. "Now I have no hope of having children, no job, no future."” <^>

Mass Sterilizations in Uzbekistan

Mansur Mirovalev of Associated Press wrote: ““According to rights groups, victims and health officials, Rakhimbayeva is one of hundreds of Uzbek women who have been surgically sterilized without their knowledge or consent in a program designed to prevent overpopulation from fueling unrest. Human rights advocates and doctors say autocratic President Islam Karimov this year ramped up a sterilization campaign he initiated in the late 1990s. In a decree issued in February, the Health Ministry ordered all medical facilities to "strengthen control over the medical examination of women of childbearing age." The decree also said that "surgical contraception should be provided free of charge" to women who volunteer for the procedure. It did not specifically mandate sterilizations, but critics allege that doctors have come under direct pressure from the government to perform them: "The order comes from the very top," said Khaitboy Yakubov, head of the Najot human rights group in Uzbekistan. [Source: Mansur Mirovalev, Associated Press, July 17, 2010 <^>]

“AP was able to interview several doctors, sterilized women and a former health official, some on condition of anonymity...The sterilization campaign involves thousands of government-employed medical doctors and nurses who urge women of childbearing age, especially those with two or more children, to have hysterectomies or fallopian tube ligations, said Sukhrobjon Ismoilov of the Expert Working Group, an independent think tank based in the capital, Tashkent. The surgeon in Rakhimbayeva's case, a burly man in his 40s named Kakhramon Fuzailov, refused to comment on her claims and threatened to turn an AP reporter over to the police for "asking inappropriate questions." <^>

“In 2007, the UN Committee Against Torture reported a "large number" of cases of forced sterilization and removal of reproductive organs in Uzbek women, often after cesarean sections. Some women were abandoned by their husbands as a result, it said. Many women, especially from poor rural areas, say they face coercion from health workers or even potential employers to agree to sterilization. <^>

Pressures in Uzbekistan to Get and Carry Out Sterilizations

Mansur Mirovalev of Associated Press wrote: “A 31-year-old mother of two from the eastern Uzbek city of Fergana said the director of a kindergarten where she sought a job told her to show a certificate confirming she had been sterilized. After consulting her disabled husband, who receives a government pension of $40 a month, she said she agreed to the procedure, produced the certificate and got the job. "We just had no choice," the woman, who gave only her first name Matluba, said by telephone from the eastern city of Fergana. She refused to provide her last name or identify the kindergarten for fear of being fired. [Source: Mansur Mirovalev, Associated Press, July 17, 2010 <^>]

“Several health workers, who spoke on condition of anonymity also because they feared dismissal or persecution, said the authorities are especially eager to sterilize women with HIV, tuberculosis or a drug addiction. Instruments often are not sterilized properly and can infect other women, they said. Inexperienced medical workers can also cause serious health complications. "Any negligence can do a lot of damage," said Shakhlo Tursunova, a gynecologist from Tashkent. <^>

“Health workers involved in the campaign are threatened with salary cuts, demotion or dismissal if they do not persuade at least two women a month to be sterilized, a former high-ranking Health Ministry official told the AP on condition of anonymity. Veronika Tretyakova, a 32-year-old doctor from Tashkent, said she came under pressure from health workers to be sterilized. "The nurse said, 'They would hang me if I let you have another child,"' Tretyakova said. "I told her to think about her soul." <^>

Image Sources:

Text Sources: New York Times, Washington Post, Los Angeles Times, Times of London, Lonely Planet Guides, Library of Congress, U.S. government, Compton’s Encyclopedia, The Guardian, National Geographic, Smithsonian magazine, The New Yorker, Time, Newsweek, Reuters, AP, AFP, Wall Street Journal, The Atlantic Monthly, The Economist, Foreign Policy, Wikipedia, BBC, CNN, and various books, websites and other publications.

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© 2008 Jeffrey Hays

Last updated April 2016


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