When USAID began working in Russia in 1992, the population was 150 million; it has since dropped to 142 million and is projected to fall below 100 million by 2050. This demographic decline is due in part to high rates of maternal and infant mortality. While Russian rates are much lower than the global average, they remain the highest in Europe, though there is great regional disparity within the country.
Treatable conditions such as hypertension, sepsis, and hemorrhaging are among the leading causes of maternal death, and over half of all infant deaths occur within one month of birth. Add in Russia’s high abortion rate—the procedure accounts for nearly one-fifth of all maternal deaths in the country—and the spread of HIV/AIDS among women of reproductive age, and remedying the situation takes on even greater urgency.
Abortion and sexually transmitted infections are also responsible for the majority of Russian infertility cases.
The Russian government has placed a high priority on building healthy families through its National Health Project and other initiatives, and USAID is working with Russia to support these efforts.
Since 2003, USAID has partnered with regional health authorities under its Maternal and Child Health Initiative to decrease abortion rates, increase access to modern contraception, prevent mother-to-child transmission of HIV/AIDS, and improve reproductive health services.
A key element of the project has been Russian ownership. Regions were selected through a competitive process that emphasized cost sharing and political support from the regional government. A top official at the regional ministry of health usually oversees the project in each region.
In 2004, USAID supported the development of a Russian NGO, the Institute for Family Health, which has become a national leader in its field.
USAID launched two new initiatives in 2008 to spread best practices at the federal level through collaboration with the Federal Public Health Institute and development of Centers of Excellence at the federal district level.
To date, USAID-financed training, technical assistance, and recommendations on improving reproductive health practices have been rolled out to 20 of Russia’s 83 regions, reaching approximately 12.5 million people.
And the impact?
In the target regions of Vologda, Yakutiya, and Perm, the maternal mortality rate has decreased between 45 and 52 percent since 2003, a rate that is twice as fast as the national average.
The use of modern contraceptives has increased by more than 15 percent, while traumas and infections in newborns have dropped precipitously, with infant mortality decreasing overall by almost 40 percent.
Abortion rates in target regions decreased at an average of 16 percent. While abortion rates have been dropping steadily for a number of years, 2007 marked the first time in decades that the number of live births in Russia outnumbered abortions. Some target regions are also beginning to report increases in their population.
The vice governor of Kaluga, Valery Loginov, praised the Maternal and Child Health Initiative for aiding in “the improvement of the quality of life for the population, the stabilization of the medico-demographic situation, the promotion of the idea of teaching the population a responsible attitude to their own health and to the health of future generations.”
There is still much to be done in this sector, and Russia’s population faces many other challenges such as alcoholism and smoking. Heart disease and other chronic ailments such as hypertension are also major contributors to the overall mortality rate. Currently, the number of deaths outstrips the number of births in the country, although deaths declined and births increased in 2007.
The Institute for Family Health, meanwhile, has developed into a strong partner for improving Russian health. In the past year, the organization won three Russian government grants totaling 70 million rubles ($2.25 million) to disseminate in 47 regions USAID’s recommendations on preventing mother-to-child transmission of HIV.
(This is a product of the Bureau of International Information Programs, U.S. Department of State.)