Improving Alcohol and Tobacco Control during Pregnancy in Ukraine
USAID ASSIST began working in Ukraine in 2014 as a continuation of an activity begun under the USAID Health Care Improvement Project (HCI) in 2013 to implement a non-communicable diseases pilot activity in Poltava Oblast, also known as “Improving Alcohol and Tobacco Control During Pregnancy in Ukraine.” The work was funded by the USAID Europe and Eurasia Bureau.
The overall goal of this activity was to demonstrate the feasibility of use in Ukraine of an evidence-based, structured counseling protocol known as the brief physician intervention (BPI) to assist pregnant women to quit smoking and stop drinking alcohol. The intervention was implemented in nine facilities in five cities of Poltava Oblast from September 2014 to March 2015.
The intervention had positive effects on the percentage of pregnant women who were counseled about quitting tobacco and alcohol use by physicians. The data indicated that, from the patient’s perspective, doctors were more likely to ask women about smoking and alcohol use and more likely to advise pregnant women who smoke or drink alcohol to stop after the BPI training.
Further, patient record reviews showed an increase in the percentage of pregnant women screened by physicians for alcohol and tobacco use from 38% at baseline (July–August 2014) to 79% in March 2015. The target of providing BPI counseling to at least 80% of pregnant women who screened positive for tobacco use in all pilot facilities was reached on average (90%). For pregnant women who tested positive for alcohol use during their first antenatal visits and who received BPI, the 80% target was slightly underachieved (74%).
The data suggest that the processes of getting information on patient alcohol and tobacco use and providing appropriate advice—particularly counseling on the effects of tobacco and smoking—improved after the BPI training and implementation.
ASSIST also supported the Ministry of Health in Ukraine by developing a national protocol for health facilities to incorporate BPI into the routine practice of health care providers in the country. The draft national protocol is being finalized for approval by the MOH and includes recommendations on BPI, the process of BPI delivery, recording and reporting tools, job aids, and referral mechanisms to specialty care.