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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!