Our Work in Russia
The Abt Associates-led PSP-One project is currently working with the Health Russia Foundation and the Center Communication Programs (CCP) on the development of a new plan for contraceptive promotion in Russia.
Contraceptive use in Russia is relatively recent and despite a rapid decline in recent years, abortion is still a preferred family planning method. Among modern methods, intrauterine devices are the most widely used, followed by condoms. Hormonal contraceptives have not reached full acceptance in Russia, but the sales of these products have reportedly increased by 160% since 2002.
Although contraceptives are overwhelmingly provided through private distribution networks in Russia, there have been limited attempts at collaboration between RH/FP programs and the private sector. As a precursor to possible collaborative activities, USAID/Russia requested an assessment of the availability and quality of modern contraceptives as well as recommendations on expanding the method mix among the general population. The PSP-One team approached this assessment as a multi-sector analysis and sought to identify common ground between public health goals and private sector interests.
The PSP-One team found evidence of substantial investment by contraceptive manufacturers in direct to consumer marketing, mostly through mass media campaigns, websites and product hotlines. Many also invest in continuing education programs and technical material for doctors, often in cooperation with public sector and donor-funded programs. In the current pro-natalist political climate, manufacturers have learned to rethink the way they market contraceptives, positioning them as a healthier alternative to abortion with proven non-contraceptive benefits. PSP-One also found that the investment choices made by pharmaceutical companies are guided by profitability and growth potential. High-margin products in high demand receive the most attention. Beyond market considerations, some companies have also determined that contraceptives are not a profitable or timely investment area and choose not to register or promote the brands they own.
PSP-One recommended that USAID seek common ground with pharmaceutical companies by focusing on hormonal methods. This strategy satisfies both public health and corporate objectives by encompassing both low-cost and high margin products, and by allowing all suppliers to benefit from market growth. There is also widespread consensus that persistent misconceptions about hormonal methods are a key obstacle to increases in contraceptive prevalence. Generic efforts to promote hormonal contraception are likely to strengthen current RH/FP programs, while going above and beyond what pharmaceutical companies are currently doing.
The PSP-One assessment team recommended basing a public/private partnership on repositioning hormonal contraception by communicating with providers and potential users about the safety, efficacy, and health benefits of hormonal methods. The team also suggested establishing regional linkages, through effort to link regional RH/FP projects with local representatives of pharmaceutical companies. Finally, PSP-One recommended monitoring product availability in pharmacies at the regional level, in order to determine potential market supply gaps.
At the request of USAID/Russia, PSP-One provided technical assistance to the Health Russia Foundation in July 2007 to develop a plan for modern hormonal contraceptive promotion in Russia. As part of the technical assistance provided, PSP-One made various immediate, mid and long term recommendations on strategies to engage the private sector and to more effectively leverage limited USAID resources for promoting modern hormonal contraceptives in Russia. A roundtable with leading contraceptive manufacturers and distributers will be a first step in implementing the strategy. The meeting will also include representatives from the USAID-funded programs and government agencies with the purpose to develop consensus for the repositioning strategy and defining roles of each stakeholder during the intervention.
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