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Success Stories

JSI Research & Training Institute, Inc. successfully implemented the Together for Health for the U.S. Agency for International Development from 2005 to 2011. For further information on project activites, visit the TfH page on jsi.com.


Creating Public Private Partnerships to Promote Hormonal Contraception and Counter Contraceptive Myths

Bayer-Schering Pharma medical representatives role-playing a doctor visit, using CATs to talk about contraceptive methods. (photo: O. Shmanko)
Bayer-Schering Pharma medical representatives role-playing a doctor visit, using CATs to talk about contraceptive methods. (photo: O. Shmanko)

July 2009 - The USAID Together for Health (TfH) project, in cooperation with Bayer Schering Pharma (BSP), a leading contraceptive manufacturer in Ukraine, conducted two seminars with BSP medical representatives and key medical opinion leaders on the application of evidence-based medicine (EBM) in promoting hormonal contraceptives with doctors and other medical professionals. The seminars marked a major landmark in the implementation of the public-private partnership (PPP) entered into by the Ministry of Health of Ukraine (MOH), TfH, and seven pharmaceutical companies in December 2006.

The workshops aimed to teach BSP medical representatives (MRs) and medical opinion leaders to use EBM in their work promoting hormonal contraception during detailing visits to doctors, roundtables with the medical community, and seminars for health care professionals. Participants practiced dispelling some of the most wide-spread myths about hormonal contraception by using clinical evidence. "Providing sound medical evidence to the medical community that supports contraceptive use is a common ground for BSP and TfH," explains Olha Shmanko, Private Sector Coordinator at TfH.

Prior to the workshops, the participants were provided with a set of 14 one-page "Critically Appraised Topics" (CATs) that summarize all of the pertinent clinical evidence proving or disproving common beliefs about hormonal contraception. Covering a range of topics concerning hormonal contraception from hirsutism to cancer and from weight gain to depression, the CATs were developed and peer-reviewed by three local EBM specialists at the National Medical Academy for Post-Graduate Education in Kyiv. The writers received guidance and support from the International Center for EBM at East Tennessee State University in the United States, who conducted the initial trainings for the writers. "The trainings and the CATs center around the key message that hormonal contraception is a safe and effective method of birth control for most women," explains Michael Thomas, one of the trainers, and veteran of the pharmaceutical marketing world. "We use role plays, focus on the data, answer the pertinent questions, and try to accentuate the aspects of EBM that would be most useful to health professionals." As the medical representatives discussed such issues as the Ukrainian marketplace opportunities for hormonal contraception, how to use CATs during detailing visits with doctors, and the health benefits of hormonal contraception, they benefited from hands-on practice using CATs in visit role plays.

The second workshop, with key medical opinion leaders, focused on bridging the gap between doctors and researchers, with participants learning the key messages involved in explaining the research that form the basis of the CATs and constructing roundtables that will be interesting and informative for the medical community. As discussion progressed, participants were eager to involve CATs in their work in order to "give doctors a quick way to see accurate, international, evidence-based research," in the words of one participant.

Also taking part in the seminar were representatives from the Moscow NGO "The Healthy Russia Foundation," who were interested in learning about TfH's approaches to addressing contraception provision in the private sector as they prepare to implement a similar USAID-funded family planning and reproductive health project in Russia. "We want to work with the private sector the way that TfH has done in Ukraine," says Sergey Simakhin, Program Manager of the Healthy Russian Foundation. "In countries as large as Russia and Ukraine, a single project can't reach every single doctor, but pharmaceutical representatives will be a very good way to dispel myths and promote contraception on a large scale."

Michael Thomas (center) discusses  using CATs in roundtables for health care professionals with key medical  opinion leaders. (photo: R. Criswell)
Michael Thomas (center) discusses using CATs in roundtables for health care professionals with key medical opinion leaders. (photo: R. Criswell)

These EBM seminars are an illustrative activity implemented within the framework of the PPP. When TfH introduced the idea of EBM seminars for medical representatives and opinion leaders, they received an overwhelmingly positive response from BSP, who contributed over $7,000 and supported 26 of their employees and 18 opinion leaders from major medical institutions, universities, and research centers in attending the trainings. "It was a continuous process of communication and searching for a common ground, both programmatically and financially" recalls Mr. Volodymyr Redko, BSP Business Unit Manager for Women's Health.

As BSP and its employees take an interest in EBM and contraceptive technology, family planning and reproductive health continue to move to the center of national health awareness. "We hope this success is only the first of many in our work with the private sector," says Laurentiu Stan, JSI's Chief of Party at TfH. "When businesses invest financially in health interventions, the impact is felt on many levels. As BSP MRs disseminates information to thousands of doctors outside of TfH's 15 target oblasts, we expect that what the knowledge and skills they gained in this workshop will be helpful to reinforce the positive messages about hormonal contraception to health care professionals who have not attended our clinical trainings."

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