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Together for Health photo banner showing the USAID logo, the Together for Health wordmark and a young couple and young family receiving family planning information. USAID logo

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.


Healthy Parents—Healthy Children; Healthy Children—Healthy Future...

March 2010 - This title is a simple truth, which today is especially relevant, as maternal and child health are becoming a priority for government policy. This targeted focus makes sense, as the health status of children, newborns, mothers, and women of reproductive age (WRA) are often far from perfect. Thus, in Ukraine, government programs are now functioning alongside international organizations' projects. When the goals of non-government and government structures coincide—it can bring significant results.

Reaching patients through doctors
The United States Agency for International Development (USAID) has been working for several years on projects in Ukraine. The Together for Health (TfH) project, for example, began implementing five-day trainings on family planning for obstetricians-gynecologists and family doctors in 2006 in 15 pilot regions.

"This training was something new for Ukraine, because part of the program was counseling and consulting clients. This included how a healthcare worker should communicate with patients, which topics and in what way they should be discussed, so they are understandable to all—a man with two degrees and a common village woman," shares Nadia Salo, deputy director of the TfH project. "But, the main condition is that, after a consultation, the doctor will not simply prescribe you pills; he or she will only help you to choose a certain pregnancy prevention method on the basis of information received."

The first task that the course developers set for themselves was to help healthcare workers and patients find a common language, with maximum benefits for the patient. In this way, they tried to reach the patient through the doctor.

Education for the people
Healthcare workers with different specialties—obstetricians-gynecologists and family doctors, midwives and nurses—have all been trained under the TfH program. Typically, within the state system, different level providers study separately, which is why sometimes their advice can differ.

Nina Goyda is one of those who actively participated in the development of themed enhancement courses for healthcare workers.
Nina Goyda is one of those who actively participated in the development of themed enhancement courses for healthcare workers. (Photo: O.Barna)

"We were aiming to create local healthcare teams, which would have one approach to selecting methods of contraception, one source of information, and the same recommendations," says Nadia Salo.

After four years of work in oblast and regional centers, after the methodology had been tested in practice and feedback was received, a question arose of incorporating the course into post-graduate education curriculum for doctors, in order to reach all regions.

"For the past few years, we have been actively cooperating with the TfH project and the areas of our cooperation are varied," says Nina Goyda, teacher at the National Medical Academy for Post-Graduate Education.

"According to the order of the Ministry of Health, a group of professionals had been formed, which developed courses of themed enhancement for healthcare workers. Today they are in use in departments of our Academy, the State Institute for Reproduction, as well as in other educational establishments of the country.

From theory to practice
Because doctors undergo certification every five years, one-week courses were developed. "Based on trainings, we developed one-week courses on the basics of reproductive health and family planning. For obstetricians-gynecologists, who should have a deeper knowledge and more detailed information, this course lasts two-weeks," says Nadia Salo.

But there was one more obstacle. While there were new plans and new curricula, they would be taught through old methods, to which students were not very receptive. "Here we were aided by international experts, who proposed to keep theory to a minimum and instead pay more attention to interactive methods, role-playing, and doing practical tasks," adds Nadia Salo. "In order to prepare teachers, together with the Ministry of Health and our National Medical Academy for Post-Graduate Education, we developed a five-day course, "Contemporary Aspects of Teaching about Reproductive Health Issues." We've held trainings for teachers at the five largest establishments in the country for medical higher education."

These five establishments include: National Medical Academy for Post-Graduate Education, Kharkiv Medical Academy for Post-Graduate Education, L'viv National Medical University, Donetsk National Medical University, and Vinnitsa National Medical University. Thus, due to the diverse geographical location of these establishments, all oblasts have been covered.

With time, a manual on family planning approved by MOH has been developed. It can be used for both trainings, and for university classes. "Of course, we are not able to provide all doctors with such manuals, but if at least several copies are available at one consulting center, then the rest of the healthcare workers at the establishment, region or village could also make use of them," says Nadia Salo.

"People were changing as we taught"
While not too much time passed since the start of the course, results were noticeable immediately after trainings. "At first, when healthcare workers came to trainings and seminars, their attitude was rather skeptical, but later they were filled with the light of understanding. People were changing right as we taught, because most of them didn't even know what interactive methodologies or role playing, etc. were... This filled them with excitement. They took an active role in discussions and asked various questions in order to adapt a certain situation to their needs," Nadia Salo shares excitedly.

Cooperation between TfH and medical universities has been very positive and is having an impact. The program will continue to support teachers if they have questions, to ensure progress continues to be made, and to keep the system working and developing.

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