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8/12/2019 Trends in Reproductive Health in Russia: Role of USAID-funded Projects and Lessons Learned, Natalia Vartapetova - FP Integration with Health Plenary
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Trends in Reproductive Health in
Russia: Role of USAID-funded
Projects and Lessons Learned
Natalia Vartapetova, MD, PhD
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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 womenhave 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 ofother health providers, and access to the
services is limited.
*RLMS, 2010
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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
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RH/MCH JSI/IFH USAID-funded projects regions
2000-2012: population over 35 million
more than 300 facilities involved
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Our approach:
Clientcentered
Evidence-based Integration
Counseling skills
Healthy lifestyle concept
Health & human rightsaspect
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Key interventions:
Policy & advocacy
Innovative training model
Protocols and Guidelines Audit
Regional level
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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
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Results: Improvements in postpartum FP services
in the project facilities,
clients interviews, facility-based survey (%)
2004 .(N 1967)
2009 .(N 2109)
Counseled on FP 31% 66%*
Decided on
contraceptive method
57% 75%*
* P < 0.01
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Results: Improvements in postabortion FP services in
the project facilities,
abortion clients interviews, facility-based survey (%)2004 .
(N 1726)
2009 .
(N 1722)
Counseled on post-abortion
contraception
74% 96%*
Knew when fertility returns 36% 58%*
Had a previous abortion
within 12 months
29% 17%*
* P < 0.01
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Results: Percentage decrease in abortions across
Russia (green) and the US-assisted project regions (red)
between 2003 and 2010
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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
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Thank you!