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.