BUCHAREST — Moving towards greater national ownership and financing of family planning programmes and strengthening the focus on demand generation are essential elements for ensuring contraceptive choice in the Eastern Europe and Central Asia region, participants said at a regional consultation meeting organized by UNFPA and the Eastern European Institute for Reproductive Health (EEIRH) in Bucharest on 16-17 November 2016.

Some 60 representatives of national authorities, civil society and UNFPA country offices attended the multisectoral consultation, which served to discuss priorities in achieving universal access to modern contraception in the region in light of the new Agenda 2030.

‘While progress has been made, major, more comprehensive, multisectoral efforts are needed in our region,’ UNFPA Deputy Regional Director Ian McFarlane said at the meeting, recalling that 17 million women in the region have an unmet need for modern contraceptives, and that 443,000 teenagers give birth and 190,000 people get infected with HIV every year. He also said the intimate partner violence experienced by one in four women in the region is unacceptable.

‘Modern contraception is a major force for good in all of our societies,’ McFarlane said.

Addressing country priorities in ensuring universal access to modern contraception, UNFPA developed a Regional Contraceptive Security Strategic Framework for the years 2017 to 2021, in close cooperation with the EEIRH and the countries of the region.

Focusing on the framework’s 5C structure – commitment, capital, coordination, capacity and client focus – participants discussed new ways to lift the region’s stubbornly low modern contraceptive usage rates.

These include governments moving away from donor dependence to full national ownership of family planning programmes, building institutional capacities for strengthened supply chains and human resources, and initiatives to generate demand among populations traditionally distrustful of modern methods.

Experiences with including modern contraceptives in health insurance plans and engaging a broader range of actors, including those in the private sector, were also shared at the event.

The important role of professional associations was highlighted by Prof. Berna Dilbaz, of Adıyaman University in Turkey: ‘If the service providers are not committed – it is not just about training, it is about the attitude, it is about recognizing reproductive health rights, and having an important role in developing the system – then it will not work. Commitment has to come from two sides: the government and the health workers.’

With contraceptive prevalence rates in Eastern Europe and Central Asia below the world average, and in some cases even below the average of the world’s least developed countries, the Agenda 2030 is seen as a new impetus in the region to make progress towards achieving universal access to contraceptive choice.

One of the strategies discussed at the meeting is strengthening the capacity of primary health care providers to deliver quality family planning services as part of a health promotion approach. ‘As in many other countries in Europe, we have some rural zones where we don’t have enough specialized doctors, so what we are doing to address this challenge is to provide capacity building to family doctors so that family planning is included in the primary health care package,’ said Mirela Cela, Director of Albania’s National Centre for Quality, Safety and Accreditation of Health Institutions.

UNFPA’s new contraceptive security strategy has been designed to assist countries in implementing the Agenda 2030, as well as the European Action Plan on Sexual and Reproductive Health recently adopted by WHO Member States and other international commitments.

The resources available in the region to support implementation of these frameworks were presented by Tahir Mahmood, President of the European Board and College of Obstetrics and Gynaecology, as well as by representatives of key partners such as the World Health Organization and the IPPF European Network.

‘There is an extraordinary knowledge in this region,’ UNFPA’s McFarlane stressed, saying that he sees UNFPA’s role as one of bringing this knowledge together and making it available to member states and their people.

‘UNFPA is a source of trusted advice to enable national authorities to take leadership across all relevant spheres.’

The meeting resulted in the development of initial national action plans for the coming year and beyond on ensuring universal access to modern contraception in the participating countries.