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Russia: The "Care For Health" Campaign

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The first national family planning promotion effort in Russia, the Care for Health campaign, helped to increase use of modern contraceptives by 12 percentage points in the targeted oblast (region) of Ekaterinburg in 1998. The campaign was one element of the larger Women’s Reproductive Health Program (WRHP) that included training for health care providers and pharmacists, advocacy and research. Together these activities also resulted in increased family planning counseling for women in the postpartum period, longer contraceptive continuation rates, and a 10-50% increase in family planning clinic attendance in the three oblasts where data were collected.

The Women’s Reproductive Health Program was initiated in 1994 by the US Agency for International Development/Moscow. The goal was to improve the health of women and children by promoting change in the current family planning communication and service delivery systems, leading to a greater use of modern contraceptive methods: condoms, injectables, intrauterine devices and pills. The Johns Hopkins University Center for Communication Programs (JHU/CCP) provided technical assistance to the campaign’s behavior change communication component, including the Care for Health campaign. JHU/CCP collaborated closely with a consortium of public and private Russian organizations including the Ministry of Health (MOH), the Russian Family Planning Association (RFPA), the University of Moscow, a commercial public relations firm and film production company, and several other agencies.

The Care for Health communication campaign used a strategic approach to increase demand for contraception as a desirable, healthy alternative . It brought family planning into the public arena and highlighted its importance to women and families. The campaign’s specific objectives included increasing knowledge and positive attitudes toward modern contraceptives, attendance at clinics, and contraceptive use. The multimedia campaign, which ran from February to July 1998, focused mainly on women ages 18 to 30.

Campaign Activities
Originally designed to reach only six oblasts, the Care for Health campaign became a national project with direct involvement and ongoing support from the Ministry of Health. Then Prime Minister Chernomyrdin subsequently wrote a directive to national television stations resulting in approximately $200,000 worth of donated airtime for the campaign. The family planning message ultimately reached women not only in the program oblasts, but also throughout Russia, and in neighboring countries.

A Russian commercial firm worked with JHU/CCP to develop television and radio spots, a family planning logo and slogan and campaign posters and souvenirs. Other activities included press conferences, a traveling lecture series, a telephone hotline, clinic open houses and disco events. Russia’s first major independent press syndicate, Globe, published over 120 articles on women’s health and family planning and a weekly newspaper column, Ask Dr. Olga.

Impact
The impact of the Care for Health Campaign was evaluated by comparing a 1996 baseline survey with a 1998 follow-up survey among women in among women in Perm (a comparison site) and women in Ekaterinburg (an intervention site) where local media, community activities and print materials accompanied national television and radio exposure as well as other WRHP activities. Clinic attendance was monitored as well.

Results showed a dramatic jump in modern contraceptive use from 46% in 1996 to 58% in 1998 in Ekaterinburg. Respondents were also significantly more likely than those in Perm to report that they had talked to a doctor or nurse about family planning after their most recent birth and more likely to have left the maternity clinic with either a prescription or the choice of family planning method.

There has also been a positive impact on contraceptive attitudes. Among those women interviewed in the two surveys, almost half of the non-users in Ekaterinburg, compared to one-third of the non-users in Perm, adopted a modern contraceptive method. In addition to these survey results, statistics collected from other regions show dramatic increases in clinic attendance.

A consortium of agencies formed during the campaign gave women throughout Russia the opportunity to see and hear the campaign’s message: Family Planning: Care for Health. Using the powerful medium of television, such widespread delivery of the message has helped the MOH recognize the need to work closely with the media and with collaborating agencies. The effort has prompted the MOH to include public health communication as a line item in its annual budget.

The Care for Health campaign demonstrates that a well developed and managed health communication program can be effective in changing behavior. The data show that Russian women are willing to accept alternatives as long as family planning information and services are made available.

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