Targeting health inequalities and improving reproductive health care for Romanian women

Targeting health inequalities and improving reproductive

health care for Romanian women

D. Iancu, N. Murgea, K. Farnsworth

JSI Research &

Training Institute, Inc., Bucharest, Romania

Romania has made strides tackling

reproductive health issues during recent years. These efforts include

confronting low levels of contraceptive use and high rates of abortion and

maternal mortality, increasing access to services for early detection of breast

and cervical cancer.

The Romanian Family Health Initiative (RFHI), a 5-year

program funded by the United States Agency for International Development (USAID)

and managed by JSI Research & Training Institute, Inc. (JSI), works to

expand access to reproductive and women’s health services to all Romanians, with

an emphasis on underserved populations.

The Government of Romania has begun to

implement health sector reforms, including the bolstering of a decentralized

primary health care system and encouraging civil society organizations to play

an active role in expanding reproductive health services nationwide. In this

context, RFHI is working to improve health services provision and availability

through a strategy of training, capacity building, health promotion, and

improving the legislative environment. RFHI supports the Ministry of Health and

a number of NGOs in improving the effectiveness of family planning, pre/post-natal

care, early detection of breast and cervical cancer, and Sexually Transmitted

Infections services. 

In the first two years, the project was implemented in 18

districts (out of the 42) with very good results: the number of service

providers increased from 260 urban Family Planning Clinics to 1,080 Primary

Health Care Centres, mainly in rural areas; the Modern Contraceptive Prevalence

Rate, measured by the Couples Years of Protection raised from 19,000 in 2001 to

61,000 at the end of 2002. In the third year, the project was extended

throughout the country. As a consequence, the contraceptive use dramatically

increased during last years.

According to the Romanian Reproductive Health

Survey performed in 2004, the Modern Contraceptive Prevalence Rate increased,

from 29.5% in 1999 to 38.2% in 2004; the increase was even more significant in

rural areas: 33% in 2004, as compared to 20.9% in 1999. Correspondingly,

abortion rate decreased from 2.2 in 1999 to 0.84 in 2004. As a result of project

successes, complementary interventions were initiated, addressing urban poor,

Roma population, and Post-Partum and Post-Abortion clients. More data will be

gathered in the coming months.

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