A Family Doctor gets Trained in Family Planning
Dr. Andor Gheorghe-Relu stood with his wife, a nurse and fellow health care provider, welcoming visitors into the entrance hall of their rural family practice in Holod, Romania. With them were three colleagues; two nurses and Violeta Bacrau, a Roma health mediator. The small, neat rooms of the clinic were decorated with posters advertising free contraceptives and other health promotion messages, which, Dr. Andor explained, "are an effective means of transmitting information, especially to young people."
Dr. Andor looks after the health of 3,000 people, approximately one-third of whom live in the neighboring Roma communities of Dumbrava and Lupoaia. Of the patients on his roster, more than 400 are women of reproductive age, and more than 100 receive family planning services. Dr. Andor had been providing family planning services to the Holod community even before he received formal family planning training from the Society for Education on Contraception and Sexuality (SECS), a partner of the Romanian Family Health Initiative (RFHI). "I appreciate the connection I have with my patients, and I am very committed to providing quality services. The added training I received from RFHI increased the level of services I can provide clients," said Dr. Andor.
Beginning in September of 2003, RFHI trained 180 family doctors in Bihor District, where the community of Holod is located. Almost all of the doctors trained began to provide family planning services in their clinics, which cover more than 82% of rural communities in Bihor. These services included the distribution of free contraceptives and other supplies, which were subsidized by the government and the US Agency for International Development (USAID). In 2004, RFHI also began training Roma health mediators to increase knowledge about reproductive health and access to those services for the Roma people.
Dr. Andor's work had a remarkable effect. Overall reproductive health indicators for the District of Bihor showed consistent improvement. The abortion rate dropped dramatically, from 5,565 cases in 2001, to 3,074 in 2005. Meanwhile, contraceptive use increased from 2,746 couple years protection in 2003, to 5,147 in 2005.
There were also noticeable differences in the two Roma communities that he visited every week. Dr. Andor found that the abortion rate in Dumbrava, which he had been visiting since 2004 and where there was a Roma health mediator, had decreased significantly during his tenure there. Meanwhile, in Lupoaia, which he had only just begun to visit and which had no Roma health mediator, the abortion rate was still relatively high.
Dr. Andor attributes the success he and the Roma health mediator had to "the good communication and collaboration we have with the community, both with men as well as with women. I really care about serving this community."
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