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Health Technical Elements
Family Planning - Reproductive Health
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| Click image above to download the PDF version of the Family Planning - Reproductive Health Fact Sheet ( Adobe PDF, 97kb) |
Overview
Modern family planning contributes to improved maternal and child health in Eastern Europe and Eurasia (E&E) and empowers women and families in decisions regarding family size and birth timing. Maternal mortality in Eastern Europe is estimated to be twice as high as that in Western Europe and complications from abortions, especially those performed under unsafe conditions, are among the leading causes of maternal death. Births that occur too early or close together also compromise a mother’s and infant’s chances of survival. Modern family planning addresses many of these negative health consequences by enabling women to better time and space their pregnancies. In many countries across the E&E region, however, access to modern family planning services and contraceptive methods is limited and relatively expensive. As a result, many women rely on traditional methods of family planning and abortion to regulate their fertility.
USAID’s Response
USAID increases access to family planning by implementing programs that provide a broad range family planning services and commodities, build capacity among health care professionals, conduct mass media campaigns, and strengthen family planning services through operations research.
Additional Information and Resources
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Family Planning Statistics
- Fertility rates: Range from 1.2 births per woman in Ukraine to 2.0 births per woman in Azerbaijan.
- Contraceptive prevalence rates (modern methods): Range from 11% in Albania to 38% in Russia.
- Abortions per woman: Ranges from 0.4 in Ukraine to 3.1 in Georgia (DHS/RH)
Unmet need for family planning remains high in many E&E countries. Armenia (15%), Ukraine (18%), and Georgia (24%) have some of the highest unmet need in the region. |
Important Issues in Family Planning in Europe and Eurasia
- Distrust of modern contraception is widespread and contributes to the heavy reliance on traditional methods. Many of these misconceptions are a result of the side effects that women experienced from the contraceptives available during the Soviet Era and from the misinformation among healthcare providers about the health risks associated with modern contraceptives. Women’s knowledge of the effectiveness of modern family planning is also limited. For example, 75% of traditional method users in Georgia believe that the method they are using is equally or more effective than modern contraceptive methods (such as oral contraceptives or IUDs).
- Limited access to family planning as a result of high cost, restricted service availability, and a lack of information is an important concern in the E&E region. Free and subsidized contraceptives are often unavailable for women who cannot afford to pay. In addition, only specially trained obstetricians/gynecologists can provide family planning, and women often have to undergo unnecessary tests and examinations before being prescribed a method. Even though many women are aware of the methods that exist, they do not know where to obtain them or how to use them.
- Although abortion rates are decreasing, the historical reliance on abortion remains an important concern. Across the region, abortion is legal, fairly unrestricted, and available at little or no cost while modern contraception is often difficult to access. With help from USAID, the rate of modern contraceptive use has increased and the abortion rate has fallen.
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| Youth receive family planning information materials from their peers in
Kharkiv region, Ukraine. |
Examples of USAID Family Planning Programs
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The C-Change Family Planning Project in Albania is increasing the use of modern family planning methods among young men and women in Albania through: increasing awareness about family planning services available in the public and private sectors, countering misconceptions about family planning methods, and improving knowledge of methods through a large multimedia public information campaign. Implementer: Academy for Educational Development (AED)
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Georgia’s “Sustain” Project is meeting critical maternal and child health and family planning needs while laying the foundation for long-term, sustainable family planning and maternal and neonatal health programs in the private sector through private insurance industry plans, existing health clinics and planned health training units. The project promotes a broader range of contraceptives available in pharmacies throughout Georgia. Implementer: JSI, Inc.
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Russia’s Improving Care for Mothers and Children Project assists 3 Russian oblasts in reducing rates of maternal and infant mortality and morbidity and reducing abortion rates through more appropriate use of family planning and modern contraceptive methods. Improvement teams at 22 health care facilities in the three project regions are working on improvements in the area of reproductive health, obstetrics and pediatrics. Implementer: University Research Co.
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The Ukrainian Together for Health Program is aimed at reducing abortion, unintended pregnancies and sexually transmitted infections by assisting Ukrainians in the adoption of modern FP/RH services and practices through public and private sectors. A key strategy for achieving goals is to foster a shift from a heavy reliance on abortion as a means of birth control to modern methods of contraception by working with health providers, youth, the pharmaceutical sector and the government. The project is currently operating in 7 of 25 oblasts and works with peer educators that reach an additional 6 oblasts. Implementer: JSI, Inc.
USAID Family Planning Success Stories
- The Romanian Family Health Initiative was a partnership established between the Government of Romania, USAID, and
JSI Research and Training Institute, and is internationally recognized as a family planning success story. Since 1993, the
percentage of couples using modern contraception in Romania increased from 14% to 40%, while the number of abortions
per woman decreased between 1999 and 2004 from 2.2 to 0.8. In addition, family planning services are being provided in
more than 80% of primary health care centers throughout the country, and now family planning is considered to be an
essential part of the national reproductive health strategy. The Initiative also had a significant impact on attitudes and
behaviors regarding family planning and reproductive health through its national health education mini-series “Real
Women.”
- The Europe and Eurasia Regional Family Planning Activity implemented by JSI was extremely successful in working
with countries across the region to integrate evidence-based family planning information into the medical education system
so that students who are training to become future service providers can develop a solid background in family planning in
order to increase service availability, improve quality, and enhance sustainability of the in-country family planning efforts.
- In Russia, the Women and Infant’s Health Project and the Maternal and Child Health Initiative was an innovative
project that successfully integrated key, evidence-based maternal and child health services with family planning. As a
result of the program, modern contraceptive use increased from 41% to 58% among women of reproductive age. In
addition, the number of women discussing family planning with their provider increased substantially in antenatal,
postpartum, and post-abortion care settings. The number of abortions also decreased considerably in project areas, from
49.1 to 43.2 per 1000 women of reproductive age. Upon the Initiative’s end, it transitioned from being an external donorfunded
project to a self-sustaining, locally-based, Russian NGO, further highlighting the incredible success of this activity.
Family Planning and Reproductive Health Resources, Websites and Links
Situation Analyses
Family Planning Situation Analysis 2007: Excecutive Summary (Adobe Acrobat PDF, 175kb)
Final Reports
Albania Documents
Georgia Documents
Regional Documents
- Europe and Eurasia Regional Family Planning Activity Factsheet (Russian) (Adobe Acrobat PDF, 156kb)
- Ten Best Private and Public Sector Practices in Reproductive Health and Family
Planning in the Europe and Eurasia Region (Adobe Acrobat PDF, 1.66mb)
- Ten Best Private and Public Sector Practices in Reproductive Health and Family Planning in the Europe and Eurasia Region (Russian) (Adobe Acrobat PDF, 255kb)
- The Rationale for Family Planning in the Former Soviet Union (Adobe Acrobat PDF, 554kb)
- The Rationale for Family Planning in the Former Soviet Union (Russian) (Adobe Acrobat PDF, 943kb)
- Improving Family Planning Pre-Service Education: Experience from the Eastern Europe and Eurasia Region (Adobe Acrobat PDF, 6.59mb)
- Private Sector Contribution to Family Planning and Contraceptive Security in the Europe and Eurasia Region (Adobe Acrobat PDF, 765kb)
- Maximizing Private Sector Contributions to Family Planning in the Europe & Eurasia Region: Context Analysis and Review of Strategies (Adobe Acrobat PDF, 527kb)
- Abortion and Contraceptive Prevalence Presentation by Charles Westoff (Adobe PDF, 134kb)
- Recent Trends in Abortion and Contraception in 12 Countries, February 2005 (Adobe Acrobat PDF)
- Reproductive, Maternal and Child Health in Eastern Europe and Eurasia: A Comparative Report - April 2003:
- Cover, Title Page, Table of Contents, Acknowledgements, List of Contributors, Preface, Introduction (Adobe Acrobat PDF, 3.83mb)
- Chapter 1: Background (Adobe Acrobat PDF, 301kb)
- Chapter 2: Methodology (Adobe Acrobat PDF, 345kb)
- Chapter 3: Fertility (Adobe Acrobat PDF, 481kb)
- Chapter 4: Abortion (Adobe Acrobat PDF, 489kb)
- Chapter 5: Contraceptive and Knowledge and Use (Adobe Acrobat PDF, 356kb)
- Chapter 6: Need for Contraceptive Services (Adobe Acrobat PDF, 312kb)
- Chapter 7: Attitudes and Opinions Toward Contraception and Abortion (Adobe Acrobat PDF, 381kb)
- Chapter 8: Maternal Care (Adobe Acrobat PDF, 463kb)
- Chapter 9: Health Behaviors (Adobe Acrobat PDF, 728kb)
- Chapter 10: Knowledge of
HIV/AIDS Transmission and Prevention (Adobe Acrobat PDF, 380kb)
- Chapter 11: Infant Feeding
Practices and Nutrition Status of Women and Children (Adobe Acrobat PDF, 399kb)
- Chapter 12: Anemia Among
Women and Children (Adobe Acrobat PDF, 338kb)
- Chapter 13: Infant and Child Mortality (Adobe Acrobat PDF, 434kb)
- Chapter 14: Sexual and Contraceptive Behavior of Young Adults (Adobe Acrobat PDF, 411kb)
- Chapter 15: Sexuality Education (Adobe Acrobat PDF, 307kb)
- Chapter 16: Physical and Sexual Abuse (Adobe Acrobat PDF, 345kb)
- References (Adobe Acrobat PDF, 184kb)
- Glossary (Adobe Acrobat PDF, 143kb)
- Appendix (Adobe Acrobat PDF, 153kb)
- An Assessment of USAID Reproductive Health and Family Planning Activities in the Eastern Europe and Eurasia Region with special reference to Armenia, Kazakhstan, and Romania, December 2004 (Adobe Acrobat PDF, 1.48mb)
Training Documents
WEBSITES
USAID Family Planning Overview
WHO Family Planning
United Nations Population Fund
WHO EURO Sexual and Reproductive Health
USAID's Family Planning Guiding Principles and U.S. Legislative and Policy Requirements
Additional Global Family Planning Resources
Johns Hopkins Bloomberg School of Public Health: The Info Project
With funding from USAID, the INFO Project houses a large library of resources available to family planning, reproductive health, and population audiences. INFO's The One Source database helps visitors search through thousands of documents, articles, photos, communications materials, online communities, and Q&As available to health care practitioners.
http://www.infoforhealth.org, http://www.infoforhealth.org/onesource.shtml
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