Substance misuse in Russia: a partnership for policy change and service development.

The paper provides an account of a joint project of education and training of doctors and nurses in St. Petersburg, funded by the Know How Fund Health Sector Small Partnership Scheme (Russia). Contextual material on substance misuse in Russia is introduced prior to focussing on the situation in St. Petersburg. Reference is made to historical and contemporary material and attention is drawn to the reliability of statistical data on alcohol and drug misuse. The aims of the project and the work carried out are outlined. The response of politicians, policy makers and health care workers to the changes in policy, provision and practice in St. Petersburg are discussed. Evidence from two evaluations is considered - an external evaluation for the project sponsors and an 'insider' evaluation. The latter utilised a framework developed by Cranfield and Stoneman. The paper concludes with a discussion of the tentative nature of education and training programmes, which involve issues regarding the suitability and transferability of educational models and therapeutic skills to a different culture.