224130 Innovations Target Improved Access to Family Planning and Evidence-Based Information in Ukraine

Wednesday, November 10, 2010 : 11:24 AM - 11:42 AM

Tetyana Goryacha , M&E Coordinator - Together for Health Project, JSI Research and Training Institute, Inc., Kiev, Ukraine
Nadiya Salo, MD , Deputy Director for Clinical Services - Together for Health Project, JSI Research and Training Institute, Inc., Kiev, Ukraine
Asta-Maria Kenney , Senior Advisor, John Snow, Inc., Arlington, VA
Use of modern contraception in Ukraine is lower than Europe or U.S. primarily due to providers' mistrust of hormonals. To change this, the USAID-funded Together for Health (TfH) project worked with the Ministry of Health (MOH) since 2005 to (1) expand access to family planning (FP) services, particularly for the poor, through primary care (PC) providers, and (2) build a sustainable system to change providers' FP attitudes and practices through Evidence-Based Medical (EBM) updates. Access to services was limited to obstetricians-gynecologists in urban areas, so TfH worked with the MOH to develop policies, protocols and training to integrate FP into PC offered by family doctors, midwives and others. Through in-service training of 2,600 PC professionals in 13 project regions, the number of access points for FP grew from under 300 to 1,155 (2006-2009.) To reinforce improved provider attitudes and practices, TfH supported institutionalization of FP training in postgraduate medical education and established an innovative system to continuously reach providers with EBM clinical updates. It prepared selected faculty from academia on EBM methodology and helped them develop Critically Appraised Topics (CATs), fact sheets addressing providers' misinformation about contraceptives. Health authorities and contraceptive manufacturers/distributors reached 5,000+ doctors with CATs and contraceptive updates through workshops and detailing visits. As a result, the proportion of health professionals with positive attitudes towards modern contraception increased from 59 to 70%. Ukraine's experience in expanding access to FP using innovative mechanisms of continuous medical education holds out promise of sustainable improvement in providers' attitudes and practices.

Learning Areas:
Administration, management, leadership
Other professions or practice related to public health
Provision of health care to the public
Public health or related laws, regulations, standards, or guidelines
Public health or related nursing
Public health or related public policy

Learning Objectives:
Identify two key strategies used to help Ukrainians shift from abortion to contraception

Keywords: Family Planning, Evidence Based Practice

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am doing monitoring and evaluation of various programs and projects for more than 10 years including 2 years in public health field. I work in USAID/JSI project 'Together for Health' as a Monitoring and Evaluation/Research Coordinator. Also I have experience as an external expert in monitoring of the 'International Renaissance Foundation' (Ukrainian Soros' Foundation) programs such as: Public health (‘palliative care’ and ‘access to drugs’ components) and Roma Ukraine (health component) and as a specialist with 5-years experience in mental health.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.