Promoting hormonal methods in Ferghana Oblast, Uzbekistan

Implemented by

ZdravPlus/

Quality Primary Health Care project

(Abt Associates)

October, 2002

Mary E. Skarie, USAID/CAR

Map of Uzbekistan

Ferghana and Uzbekistan dataUzbekistan

Data 1999 2000 2001

Birth Rate 22.4 21.4 20.4

Abortion Rate* 9.4 9.0 8.4

% Contraceptive Users 58% 59% 42.7%

% IUD Users 46,7% 45% 38.2%

% OCP Users 6,5% 5,7% 2.1%

% Indictable Users 2,2% 2,5% 1.6%

Ferghana Oblast

Data 1999 2000 2001

Birth Rate 21.1 20.0 18.7

Abortion Rate* 6.7 5.0 5.1

% Contraceptive Users 71.1% 66.5% 60.4%

% IUD Users 52.8% 55.4% 54.9%

% OCP Users 12.5% 6.5% 2.0%

% Indictable Users 5.8% 4.6% 3.5%

* Abortion is under-reported in official data as mini-abortions (menstrual extractions) performed before 6

weeks are not reported as abortions and private clinics do not report abortions.

Program components

refresher training at rural PHC level for GPs and midwives

training for ob-gyns to improve their knowledge of hormonal methods and management of side effects

reference materials in Uzbek

contraceptive/procurement

logistics system design and implementation

Initial results and next steps

Issue: Post training monitoring showed improved clinical skills but need to develop counseling skills

Planned Intervention: Interpersonal counseling skills training

Issue: Focus groups with women and men indicate cost, inconvenience and fear of side effects are main concerns about hormonal methods

Planned Intervention: Reproductive health campaign including soap opera, clinic-based health education, NGO activities and print materials

Impact to date: Three Pilot Rayons in Ferghana

1999 2000 2001• Women using contraceptives 613.8 446.1 723.0

(any) (per 1000 women)

• Women using IUD (percent of users 89,1% 93,3% 47.5%

among all contraceptive users)

• Women using hormonal pill 10,3% 4,3% 22.9%

(percent of users among all

contraceptive users)

• Women using injectables 0,6% 3,0% 21.7%

(percent of users among all

contraceptive users)