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.
Public-Private Partnership Focuses on Pharmacies
February 2008 - Case Study: Pharmacies in Ukraine stock a wider range of contraceptives
The ability to plan pregnancies makes it more likely that a family can live within their financial means. And when people have access to a range of reasonably-priced contraceptive options, they have healthier families. In the past, many Ukrainians have had a difficult time accessing high-quality, affordable contraceptives in the oblasts (regions) in which they live. Pharmacy managers, unaware of how multiple, affordable contraceptive options could benefit their communities, did not stock a mix of contraceptive methods: in Kharkiv oblast in 2006, only one out of 89 pharmacies sold a complete method-mix of contraceptives. And in Lviv oblast, not a single pharmacy out of 85 sold a complete method-mix of contraceptives.
Access to a variety of contraceptive methods is necessary for a woman to safely and effectively manage her fertility. USAID's Together for Health (TfH)project addressed the lack of affordable contraceptives and the narrow range of contraceptive options by creating a public-private partnership between the Ukrainian Ministry of Health and international and Ukrainian contraceptive manufacturers and distributors. The partnership promotes a "Contraceptive Availability Minimum Package," which includes a range of mid- and low-priced contraceptive brands that are available in the Ukraine, and examples of a complete method-mix inventory—such as pills, injectable contraceptives, IUDs, and condoms—for oblast pharmacies. The public-private partnership also offers a pharmacy certification program, which includes a one-day family planning training for pharmacists and provides educational materials for the pharmacists to distribute to customers. Pharmacies that take part in the certificate program receive a "family planning-friendly" logo to place in their window. And in exchange for stocking a full range of mid- and low-priced contraceptive brands, the pharmacies are promoted through a local mass-media campaign.
A year after the pharmacy initiatives were introduced, the number of pharmacies carrying a complete method-mix of low- to mid-priced contraceptives increased from one to seven in Kharkiv, and from zero to one in Lviv. The participating pharmacies carry more lower-priced oral contraceptives, and have increased the availability of injectable and emergency contraception. Although these results are modest, they are a positive sign. As the pharmacy certification program is promoted and word of it spreads, the public-private partnership and TfH expect the number of pharmacies stocking the complete contraceptive method-mix to increase.
A family planning-friendly-certified pharmacy displays a poster on contraceptive methods. (Photo: Irina Kolchina)
The program's success would largely depend on the knowledge of the population. Radio, TV, printed and electronic mass media play a vital role in promotion of social advertising, thematic reports and articles, films and talk shows. "At first, we provided trainings to journalists to help them master the art of writing articles on diverse health topics, however we realized that we would be more effective if we were to address them as men and women," said Natalia Karbowska. "Thus, we started training health professionals on FP/RH issues for them to be able to pass this knowledge on to a listener or a viewer further on down the road. We're also trying to get them to participate in various contests held during the FP Week."
In whole, there are 5-6 behavior change communication (BCC) trainings held each month in Vinnytsa oblast, including seminars, communication activities, actions, and sessions. Two groups are usually involved in these activities—and adults. Youth are the primary target audience because they are easy-to-reach through diverse educational establishments.
"Large public events are held on certain holidays. We develop brochures, questionnaires, and booklets to distribute among youth during these events. Sometimes we also get them involved as volunteers," says Natalia Antonuk. "The youth are being very active, searching to expand collaborative efforts and make a personal contribution."
Oblast residents are particularly fond of health fairs"—activities promoting healthy lifestyles for the future. It is well-known that children are our future. In addition to having basic information, youth often take creative approaches to tackle various issues. Organizers use contests, animation sessions, and games to trigger the interest of the population. "Of course, teenagers are our primary and very important audience; however, we are trying to reach the adult populations as well," says Natalia Karbowska. "We're introducing not only medical postgraduate trainings and courses, but pedagogical ones as well. We focus predominantly on men; however, it's not a secret to anyone that family planning issues are often put on women's shoulders."
Collaboration with health and educational facilities, private and public organizations, the mass media, involvement in trainings, seminars, communication activities, and introduction of FP courses into postgraduate education are all key puzzle pieces. Each of these pieces helps to make BCC activities implemented by the Together for Health project in Vinnytsa oblast complete and successful.
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