Family Doctors Counsel Patients on Reproductive Health
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Jim Loftus, discribed modern techniques used in the last U.S. elections, while Donika Kadaj, Member of Parliament listened.
Photo Credit: J. Dzioba |
Until recently, rural Ukrainian women requiring family planning and reproductive health (FP/RH) care had to go to obstetrician-gynecologists (OB/GYNs), usually located in town and cities. Recognizing this situation as a significant barrier to accessible care, USAID's Together for Health(TfH)project set out to make a change. By training OB/GYNs, family doctors, and mid-level health workers in 13 oblasts in Ukraine, the project effectively expanded FP/RH services to the primary health care level in local communities.
When TfHinitiated trainings in 2006, only 293 health facilities in seven oblasts provided FP/RH services. Within two years, this number tripled and continues to grow. Family doctors, internists, midwives and feldshers(nurse practitioners) are now trained to provide FP/RH services, which has increased access, especially for women in semi-urban and rural areas. In Kharkiv Oblast alone, the number of facilities offering FP/RH has skyrocketed from 58 in 2006 to more than 250 in the beginning of 2009. Most of that expansion has occurred in the areas outside of the oblast and rayon centers.
TfH clinical trainings are designed to help health professionals better understand the concepts of client-centered care, family planning counseling and modern contraceptive technology. So far, the trainings have successfully accomplished their goal of bringing FP/RH closer to people.
Nikolai Faida, a family doctor working in Komsomolsk, Poltava Oblast, has included more comprehensive family planning services into his practice after he attended a TfH training. His 1,900 patients, out of whom more than 1,200 are women of reproductive age, can now receive qualified information and services from their family doctor close to home instead of traveling to the rayon hospital for these services.
Particularly useful for Faida—and beneficial to his clients—was the information on contraceptive methods, including oral and emergency contraception, and voluntary surgical sterilization. Since he started consulting his patients, Faida has noticed an increase in the use of modern contraceptive methods in his area. “I work with some women who have been using traditional methods for 20 years,” he explains, “and now they have chosen to switch to modern methods. My practice is a perfect place for women of any age to receive information about family planning, because they come for advice before they have serious problems. I am now doing all I can to make sure everyone knows about and can use the method that she chooses.”
Antonina Perepelets, a family doctor from Zhokva, Lviv Oblast, is also pleased with her enhanced practice. Counseling techniques she learned during the training have been particularly useful in her work with adolescent girls. “I didn’t really know how to talk to teenagers about these issues,” she explains. “But they are such an important group for family planning and safe sex practices. After the training I felt like I could better address their needs.” The information Perepelets received about oral contraceptives helped to reveal that many of her own fears about hormonal contraception were unfounded. She now feels well prepared to discuss this option with women of any age. Perepelets says that she “sees more than ever the crucial preventative role that primary care physicians play in family planning and helping to promote a healthy next generation.”
A major part of family planning is providing information and counseling so that women and men can reach their own decisions about whether to use contraception and, if so, the best method to use. The TfH trainings have already provided about 3,500 health professionals throughout Ukraine with the information and skills necessary to guide their patients through the contraceptive decision-making process. With family doctors like Faida and Perepelets providing FP/RH counseling and services, Ukrainian women receive accurate information and services from new sources. As more and more women of reproductive age get access to quality FP/RH services from primary health care workers, Ukraine is getting one step closer, as Perepelets puts it, to “a healthier future.”
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