Trends in Reproductive Health in Russia: Role of USAID-funded Projects and Lessons Learned

Natalia Vartapetova, MD, PhD

Objectives of the presentation:

Describe trends in reproductive health and services in Russia Explain key approaches and interventions of the USAID-funded RH/MCH projects Present results in PP & PA FP Discuss lessons learned

Background:
The fertility rate in Russia is low (1.5) The majority of women would prefer to have fewer than 2 children.* Abortions decreased but half of all women have had at least one abortion.* The social and political acceptance of modern FP is uncertain among various groups FP is a vertical service, lacks the attention of other health providers, and access to the services is limited. *RLMS, 2010

Aim of the USAID-funded MCH/RH projects:

Decrease abortions and improve access to and quality of RH/FP services

Integration of FP across maternal and infant care

RH/MCH JSI/IFH USAID-funded projects regions 2000-2012: population over 35 million more than 300 facilities involved

Our approach:

Client centered Evidence-based Integration Counseling skills Healthy lifestyle concept Health & human rights aspect

Key interventions:

Policy & advocacy Innovative training model Protocols and Guidelines Audit Regional level

Results:
Methods: facility-based survey conducted in 2004 and 2009 in 10 core regions with total 11,568 clients interviewed
MOH data to assess abortion trends in Russia and the project regions in 2003 and 2010

Results: Improvements in postpartum FP services in the project facilities, clients interviews, facility-based survey (%)

2004 .
(N 1967)

2009 .
(N 2109)

Counseled on FP
Decided on contraceptive method

31%
57%

66%*
75%*

* P < 0.01

Results: Improvements in post abortion FP services in the project facilities, abortion clients interviews, facility-based survey (%) 2004 . (N 1726) Counseled on post-abortion 74% 2009 . (N 1722) 96%*

contraception
Knew when fertility returns Had a previous abortion within 12 months
* P < 0.01

36% 29%

58%* 17%*

Results: Percentage decrease in abortions across Russia (green) and the US-assisted project regions (red) between 2003 and 2010

What worked (lessons learned):

Integration and continuation of services Focus on individual informed choice Technical excellence Regular technical and information support Job aids for providers and IEC materials for women International collaboration

Thank you!