‘Survey of women-IDUs’ access to medical services’

Timeframe: 01.12.2011 — 31.07.2015.   Funded by: Open Society Institute.   Location: Kaliningrad, Naberezhnye Chenly, Orel, Saint Petersburg, Tolyatti, Tomsk.   Description:   For more…

Timeframe: 01.12.2011 — 31.07.2015.
Funded by: Open Society Institute.
Location: Kaliningrad, Naberezhnye Chenly, Orel, Saint Petersburg, Tolyatti, Tomsk.
For more than four years, NP ‘E.V.A.’ conducted systematic work on monitoring the situation and improving access to medical services for pregnant substance users during their pregnancies.
This work began with a study of problems, which women who are substance abusers face during their pregnancies (‘Monitoring the access of women IDUs, including pregnant women, who use substances, to reproductive health services along with narcological types of assistance’: link to the project’s sociological report (in Russian)). A total of 213 women were surveyed in six regions of Russia (Kaliningrad, Naberezhnye Chelny, Orel, Saint Petersburg, Tolyatti, Tomsk). The research uncovered the following issues in the provision of medical care for pregnant substance-addicted women: 88% of those surveyed tried to quit or reduce the amount they were using, independently, or to change to a less dangerous method of use during pregnancy. At the same time, only 20% of the women sought help in the state narcological institutions and of them 74,4% went through medical detoxification and the rest were refused due to their pregnancy. 5% were initially suggested to have an abortion. Among the women surveyed, 10% attempted to be rehabilitated in inpatient care and no one of them were able to receive care.
The data received from the study was presented several times at international and domestic conferences (link to the policy brief (in Russian)). In parallel with presentation of the data, there was a strategic planning for further work in this area: for constructive dialogue with officials on the data that was gathered was deemed insufficient and the decision was made to examine the opinions of public health organizers, medical personnel, and the staff of non-profit organizations about what the main problems of this group of women are in seeking medical care. The final project report included analyzed data from interviews with infectious disease doctors, neonatal doctors, gynecologists, and narcologists. A separate chapter in the report describes the ‘best practices of working with substance addicted pregnant women’, which outlines successful experiences of the work of three regional non-profit organizations from Naberezhnye Chelny, Saint Petersburg, and Tomsk.
Pregnancy is a powerful stimulus for women to give up drugs and start treatment for addiction. However, there are no special recommendations in providing narcological care for women during pregnancy in the Russian Federation. At the federal level this group of women are not given their own category in regulations as it is done in clinical protocols and recommendations of the WHO. The standards of narcological assistance that are approved by the Russian Federation’s Ministry of Health do not include specialized care upon pregnancy whereas among pregnant women in Russia, up to 11% abuse substances. Considering that substance use during pregnancy can harm the health of the mother and future child, regular prenatal surveillance and timely and quality care can significantly reduce the risks of substance use.
Link to the report ‘Other Patient Syndrome’ (in Russian).

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