USAID Romania Family Health Initiative Romania Family Health Initiative

RFHI Health Inequalities Component

Context · Main Activities · Key Results

After the rapid expansion of FP services in rural areas nationwide, a new project program component was added to address other populations in need: ethnic minorities and low-income communities in urban areas. The program aimed to reduce inequalities in accessing existing RH services for both groups.

Component Adressing the Urban Poor (2005-2006)


Despite the fact that most poor Romanians live in rural areas, nearly 11 percent of the total urban population is poor or very poor, with reduced access to RH/FP services. RFHI Urban aimed to improve the access of underserved families in the 11 most populous Romanian cities to services and to increase their use by integrating service provision at the community level. These cities included: Bacau, Brasov, Braila, Cluj-Napoca, Constanta, Craiova, Galati, Iasi, Oradea, Ploiesti and Timisoara. For the first time in Romania, city halls and other local authorities participated in such an effort and, together with local health authorities and civil society representatives, identified realistic, sustainable solutions to the health needs of impoverished city inhabitants.

RFHI instituted a multi-sectoral and collaborative effort, bringing together various professionals and public and private-sector representatives to ensure full coordination across relevant sectors and services. RFHI also built local capacity using a learning-by-doing process.

These collaborative ties were enacted through formal agreements among local partners, including mayors' offices, district public health authorities, insurance houses, directorates of child protection and social assistance, labor and social solidarity offices, education inspectorates, police, and nongovernmental organizations representing civil society.

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Main Activities

  • Set up local partnerships and mobilized partners to implement —in a coordinated fashion— activities aimed at increasing access to RH services.
  • Identified and trained health providers who are well-positioned to support increased access to RH services (e.g., FP physicians, family doctors).
  • Designed information, education, and communication tools:
    • Developed an educational kit on modern contraception for women in factories Among Us Women
    • Developed an education campaign for journalists Daily Subject aimed at combating myths and misconceptions around contraception
    • Produced jointly with partner NGOs the TV mini-series True Women
  • Conducted communication campaigns aimed at motivating women to change behavior and to exercise their RH right to receive free contraception and counseling services

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Key Results

  • Increased awareness of local stakeholders and partners about health inequalities and population need
  • Signed Partnership Agreements between local public authorities and NGOs in all 11 cities and set up local coordination groups of partner institution representatives that designed local action plans and sustainability plans
  • Improved cross-sector communication, pooling resources across the health and social sectors, and built mutual trust among partners
  • Exposed new entities (NGOs, police, social services) to RH issues and started allocating resources and providing integrated information and/or services for FP/RH
  • Provided training in management for local coordination groups to develop their own strategies and sustainability plans
  • Trained over 700 doctors and nurses in FP counseling and 1,100 social workers attended sessions on providing information about the benefits of FP;
  • Developed new FP services through the General Directorate of Social Assistance and Child Protection or local NGOs in some of the cities;
  • More than 110,000 beneficiaries attended information sessions, and almost 500,000 women viewed the True Women mini-series broadcast on local TV stations

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The Romanian Family Health Initiative (RFHI) is implemented by JSI Research & Training Institute, Inc.
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Financial support for this website was provided by the U.S.Agency for International Development,
Romanian Family Health Initiative (RFHI) Cooperative Agreement #186-A-00-01-00103-00.
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