What else health care can do to decrease abortions: Lessons learned from USAID-funded projects in Russia

The abortion levels in Russia remain high. USAID-funded RH/MCH projects from 1999 through 2012 proposed a new framework and approaches to help Russian healthcare to respond to reproductive health needs. Integration of the evidence-based FP across the spectrum of health services was central to the project’s strategy and implementation. To measure health outcomes and actual improvements in health services three rounds of the facility-based survey were conducted in 2004, 2006 and 2009 with total 17,509 clients interviewed in the projects regions. Ministry of health data were used to assess abortion trends. The data show a large increase in the percentage of clients reported having been counseled on contraceptive methods from 34% of antenatal clients, 31% of post-partum and 79% of post-abortion clients in 2004, to 48%, 58% and 96% respectively in 2006; and 56%, 66% and 96% in 2009. The percentage of post-partum and post-abortion clients reporting modern contraceptive use after discussion with a provider were roughly similar, at 75% and 79%, respectively in 2009 demonstrating an increase from 2004 (57% and 73%) and 2006 (65% and 78%). The percentage of abortion clients who reported having last abortion within part 12 months decreased from 29% in 2004, to 19% in 2006 and to 17% in 2009. Between 2003 and 2010, across Russia the number of abortions per 1,000 women decreased 34% and the number of abortions per 100 live births declined 48%. In the projects regions the abortion rate declined 52% and the abortion ratio – 60%.