30 June 2008

U.S. Helping Ukrainians Get Access to Family Planning Services

Pharmacies encouraged to expand the range of contraceptives

Volunteers from the nonprofit Together for Health work at an event in Lutsk. The nonprofit receives support from USAID.

By Jonathan Schaffer
Staff Writer

Washington -- Like patients in most countries in Eastern Europe and the former Soviet Union, people in Ukraine look to pharmacists for health care as much as to doctors. Recognizing this, Ukrainian pharmaceutical industry representatives and the government have joined forces to provide both types of health professionals with training, low-cost family planning information, services and supplies.

Launched in December 2006, the Together for Health (TfH) public-private partnership aims to shift Ukrainians away from widespread use of abortion to use of modern contraception. The partnership brings together the Ukrainian Ministry of Health and seven national and international manufacturers and distributors of contraceptives

With funding from the U.S. Agency for International Development (USAID), TfH provides pharmacists, doctors and other health workers with training to ensure they have both the knowledge and the supplies to offer quality family planning and reproductive health services.  Training includes topics such as human physiology, the advantages and disadvantages of the different methods of contraception, and family planning counseling.

"The project’s work in only two years is impressive,” said Raisa Moiseenko, head of Mother and Child Health at the Ukraine Ministry of Health, “and we’d like it to expand to all regions of Ukraine. The training for health professionals is needed all over the country, and the population should be given accurate information to dispel myths and misinformation."

Initially started in two provinces, Lviv in western Ukraine and Kharkiv in the east, the project plans to operate in half of Ukraine’s 27 administrative regions by the end of 2008.  To date, more than 2,500 health workers and more than 2,000 pharmacists have received training and information through TfH.

Previously, free or low-cost contraceptives were hard to find for many Ukrainians, whose average monthly salary is $200.  While pharmacies are readily accessible in most rural and urban areas, less than 1 percent of them have a full range of contraceptive methods available -- from pills and condoms to intrauterine devices and emergency contraception. Many of the brands sold in Ukraine are expensive, later-generation contraceptives not affordable to many middle- and low-income families.  USAID estimates that less than 25 percent of the need for mid- and low-priced brands is being met.

TfH asks participating pharmacies to stock a range of mid- and low-priced contraceptive brands and to provide information for clients and display educational materials. USAID officials state that participation is encouraging, but full access has not yet been achieved. This is partly due to the fact that the overall contraceptive market is still in its incipient phase and sales are low.

However, participation is growing.  PoltavaPharm, the largest pharmacy chain in Poltava Oblast in central Ukraine, has sent more than 200 employees from 275 pharmacies to participate in the training. “Women feel better, work better and live better when they feel healthy and confident,” Natalia Stetsyuk, director of PoltavaPharm, said in a recent USAID report. “And if we as a pharmacy chain can establish ourselves as a reliable source of information to help women stay healthy, it will pay off both socially and financially in the long run.”

USAID is urging both federal and regional governments to expand public funding for distributing contraceptives to the poor and disadvantaged. And for the first time, the central government and more than two-thirds of the provinces have allocated funding for contraceptives for these groups. This results in a solid foundation for Ukrainians, rich and poor, to begin planning their families.