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New laws limit access to family planning in Colombia.


 Two recent laws adopted by the Colombian Ministry of Health have had a detrimental effect on access to family planning (FP) services and have affected AVSC's work in that country, which is widely regarded as a trendsetter in reproductive health and FP among Latin American nations. One of the laws, which went into effect in 1993, provides universal health care regardless of ability to pay and allows people to choose between public or private health facilities. This law fails to specify, however, which FP services are covered, and the new agencies that act as liaisons between individuals, employers, and hospitals or clinics are unwilling to provide coverage for sterilization or contraception. Individuals who have paid for insurance resist paying an extra amount for contraception. The other law, enacted in 1991, restricts the delivery of anesthesia to anesthesiologists. In hospitals without full-time anesthesiologists, this has impeded delivery of many outpatient surgical procedures or treatment of incomplete abortion. It also prevents performance of female sterilization under local anesthesia. The laws have halted much of AVSC's work in establishing services for female sterilization under local anesthesia in public hospitals. AVSC has responded to the laws by working to help public and private sector providers manage the changes, producing a public information brochure, disseminating the law to service providers, and training anesthesiologists to promote female sterilization. In 1996, the 1993 law was clarified to ensure access to reproductive health and FP services.
