Romanian Family Health Initiative: Health Inequalities Component

Collaboration was a central strategy in this multi-sectoral effort to reduce inequalities in accessing existing RH services among underserved families in the 11 most populous Romanian cities. RFHI brought together various professionals and public- and private-sector representatives to ensure full coordination across relevant sectors and services. Amongst those working together to identify realistic, sustainable strategies for meeting the health needs of impoverished city dwellers were mayors' offices, district public health authorities, insurance houses, directorates of child protection and social assistance, labour and social solidarity offices, education inspectorates, police, and non-governmental organisations (NGOs). In fact, formal partnership agreements were signed to ensure that local public authorities and civil society in all 11 cities would join in setting up local coordination groups of partner institution representatives that would develop local action plans and sustainability plans.

RFHI also built local capacity using a learning-by-doing process. Training in management for the aforementioned local coordination groups was offered. In addition, organisers identified and trained health providers whom they considered well-positioned to support increased access to RH services (e.g., family doctors). Approximately 700 doctors and nurses took part in FP counselling training, and 1,100 social workers attended sessions on providing information about the benefits of FP.

Through this cooperative process, RFHI and various partners created several information, education, and communication (IEC) tools in an effort to stimulate awareness about, and demand for, these services. These tools included:

• An educational kit on modern contraception for women in factories called "Among Us Women" (distributed as part of a workshop programme facilitated by medical doctors in textile factories).
• An education campaign for journalists designed to combat myths and misconceptions around contraception - Population Services International (PSI) Romania, developed and implemented "Un Subiect Codian" (A Daily Subject) in an effort increase the quality and quantity of media articles on hormonal contraception. RFHI distributed fact sheets entitled "Hormonal Contraception Decreases the Risk of Genital Cancers," "Beauty, Femininity & Contraception," "Clearing up Misconceptions on Emergency Contraception," and "Non-Contraceptive Benefits of Hormonal Contraception." Journalists and media were also provided with key websites where they could find more in-depth information and research on modern contraception.
• The TV mini-series "True Women" - Produced by PSI, this series wove RH messages into a dramatic plot. Shown over the course of a few months in 2006 on television and in behaviour change communication (BCC) programmes for RH, "True Women" sought to catalyse discussion in a culture in which talking about issues like menopause, puberty, contraceptives, and sexual debut is still taboo. One plot line featured a woman resisting her husband's pressures to have an abortion. A local government representative from the public health authority in Oradea said that after airing the series, "the number of clients in family planning clinics tripled."

RFHI also conducted communication campaigns aimed at motivating women to change behaviour and to exercise their RH right to receive free contraception and counselling services.

Family Health, Reproductive Health, Women, Rights.

According to RFHI, for many years, Romania has had one of the highest abortion and maternal mortality rates in Europe. More than half of maternal deaths are caused by complications from abortions.