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Success Stories

Romania's Family Planning Success Goes Forward

After the fall of the communist regime in 1989, Romania was hailed worldwide for its success in making family planning (FP) services widely available. Yet the country still lacked standardized FP pre-service (medical school) training for medical doctors. Collaboration between Romanian medical school professors, OB/GYNs, family planning trainers/doctors, and contraceptive advocate and author Dr. Robert Hatcher helped the country move toward the adoption of a standardized FP curriculum in medical schools.

In 2003, the Romanian Family Health Initiative (RFHI), and the Ministry of Public Health (MOPH) began a nation-wide FP in-service training program for family doctors. RFHI, which was funded by the United States Agency for International Development (USAID) and implemented by JSI Research & Training Institute, Inc. (JSI), developed the training curriculum, which was based on WHO eligibility criteria. JSI also supported the training, and the entire effort was so successful that within five years of the project, 80% of rural areas were covered by a family doctor who had received the in-service FP training.

Dr. Hatcher with his "Managing Contraception" pocket guides at the Celebrating Fifteen Years in Family Planning Conference in Bucharest, September, 2006.The momentum from the success of the national in-service training program solidified the presence of FP services in Romania on a basic level and paved the way for the standardization of pre-service FP training. Collaboration for this pre-service objective began in September of 2006 when Dr. Hatcher was the invited to Bucharest as the guest lecturer for the conference "Celebrating Fifteen Years of Family Planning in Romania." Dr. Hatcher's interest in collaborating with Romanian physicians stemmed from what he called "Romania's gift to the world" and the most remarkable example of a national family planning success story. Dr. Hatcher discussed topics such as management of hormonal contraceptives, postpartum and postabortion contraception, and new contraceptive methods. He encouraged the use of his pocket guide Managing Contraception, which he wrote to support the daily decision making of physicians providing FP services. In a generous demonstration of his continuing support of Romania's transition to a standardized family planning curriculum, Dr. Hatcher donated 2,000 copies of Managing Contraception.

Dr. Hatcher's investment did not end there. In April 2007, Dr. Hatcher and an associate, Dr. Carrie Cwiak, conducted a three-day training in Brasov on an interactive method for teaching contraceptive technology. Attendees included medical school professors from eleven medical schools, and FP doctors, who advocated the importance of other health professionals' role in providing FP services (which historically had been an extremely controversial issue between OB/GYNs and FP trainers/doctors).

At the workshop on teaching techniques and contraceptive technology, Brosov, Romania. April, 2007. Drs. Hatcher (right) and Cwiak (middle) pose with a participant.The workshop covered in greater detail the topics that Dr. Hatcher had discussed at the 15-year FP anniversary conference. Drs. Hatcher and Cwiak also trained the medical professors and practitioners to use the Managing Contraception guide and become more comfortable with interactive teaching methods. They also provided training on how to improve the quality of contraception services offered to clients. The sessions were participatory and evoked useful debates among the professionals in attendance, particularly with respect to the WHO eligibility criteria for contraceptive use.

At the end of the workshop, the group of medical school professors committed to using the contraceptive technology course with their sixth-year medical students. Many said they would begin teaching the week after the training. Others looked forward to introducing the new curriculum in the fall semester. In a medical education system steeped in bureaucracy and sometimes resistant to change, the introduction of a new technical topic was a major achievement.

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