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Healthcare

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Nurse with babyOver the last decade the Government of Armenia has progressively supported Primary Health Care (PHC) system strengthening efforts. Support from USAID and other donors has resulted in the scale up of successful PHC models and major institutional reforms.

Major accomplishments to date include:

  • USAID assistance has also led to substantial progress in equipping and renovating about two-thirds of Armenia’s neediest rural health facilities, a Basic Benefits Package available to all Armenian citizens extending free PHC and maternity services, and improved family medicine doctor and rural health nurse skills throughout the country. 
  • An Open Enrollment (OE) system was instituted whereby every resident of Armenia has a right to choose his/her own health care provider (2.5 million people are now enrolled in OE computerized database, which amounts to 85%-90% of resident population of Armenia).
  • New systems of health care financing and monitoring were established. 
  • Government spending on Primary Health Care has increased (from 15% to 35% over the last 10 years).
  • Quality Assurance practices were introduced to improve the quality of PHC services nationwide.
  • Family medicine practices were introduced.
  • The primary cause of maternal death in Armenia – post-partum hemorrhage rates – was reduced by over 60% going from 5.4% in 2005 to 1.7% in participating facilities.
  • Primary health care was advanced including training of 25% of Armenia’s PHC physicians.

Building upon past accomplishments, USAID programs in the health sector continue to foster increased use of health services while addressing the challenges of institutionalizing quality and efficiency in the Armenian health care system. Maternal and child health (MCH), reproductive health and family planning (RH/FP) and Tuberculosis (TB) continue to be the priority areas for USAID interventions in Armenia, thereby contributing to a significant reduction in maternal and child morbidity, mortality and abortion rates, as well as to early diagnosis and successful treatment of TB.

To improve quality of PHC service delivery, USAID programs strengthen the clinical and managerial skills of health care providers, strengthen PHC facility management, improve health knowledge and demand for services through community mobilization and health education efforts, and strengthen PHC referral systems to promote early diagnosis and disease prevention.  USAID also supports mobile outreach teams to ensure PHC services are available to vulnerable groups in remote communities with limited access to healthcare services.

CURRENT ACTIVITIES

Primary Healthcare Reform (PHCR) Project (09/2005-09/2009, $13.7m):  The activity supports the GOAM/Ministry of Health to introduce primary healthcare (PHC) reform and increase the utilization of sustainable, high-quality primary healthcare services in Armenia. The project has six components: (1) health care reform and policy support (including renovation and equipment of facilities), (2) open enrollment, whereby every resident of Armenia has a right to choose his/her own healthcare provider, (3) family medicine, (4) healthcare finance, (5) public health education, and (6) quality assurance. The project will be expanded until the entire country is covered.  [Implemented by Emerging Markets Group, Ltd.]

Project NOVA (Innovations in Reproductive Health) (10/2004-09/2009, $8.1m):  NOVA works with the MOH to improve the quality of reproductive, maternal and child health (RH/MCH) services. To this end, NOVA increases the knowledge and improves the clinical skills of rural PHC providers, and provides basic PHC medical equipment and supplies.  NOVA develops the capacity of regional health managers to manage and supervise rural facilities, accelerates the momentum of reform in the health delivery system to be more responsive to the reproductive and child health needs of the population, and increases consumer demand for high-quality RH/MCH services through community education and mobilization activities. [Implemented by Emerging Markets Group, Ltd.]

eyecare
As part of USAID/Armenia’s Global Development Alliance with the Armenian Eye Care Project, an ophthalmologist provides free screenings for patients.

Armenian Eyecare Project (AECP) (10/2004-09/2011, $1.6m):  A Global Development Alliance project, AECP employs four main strategies for providing high-quality ophthalmology services using a mobile eyecare truck: (1) outreach, screening and treatment of vulnerable populations; (2) medical education and training program for regional ophthalmologists and family (primary care) physicians and ancillary personnel; (3) public communication and education programs; and (4) epidemiology. AECP works nation-wide according to a pre-determined schedule. [Implemented by Armenian EyeCare Project]

Armenian-American Wellness Center (AAWC) (10/2004-09/2010, $1.4m):  A Global Development Alliance project, AAWC has a large clinic in Yerevan, a satellite clinic in Gavar, and provides outreach visits. AAWC primary healthcare services include annual physical examinations, health promotion, breast and cervical cancer screening, diagnosis and referral services, gynecological services including STI management, and monthly outreach missions. AAWC provides periodical training to update clinical and managerial skills of Center staff and has also developed a quality management system for accurate reporting, cost accounting and patient record keeping. [Implemented by the Armenian American Cultural Association Center, Inc. (AACA)]

WHO grant on Technical Assistance of Tuberculosis (TB) services:  USAID/Armenia is providing technical assistance to develop TB policy documents and a TB control training package in accordance with international recommendations focusing primarily on the provision of TB services at the primary health care level.

FUTURE DIRECTIONS

USAID will build upon past accomplishments continuing to focus on increasing the use of health services while addressing the challenges of institutionalizing quality and efficiency in the Armenian health care system. USAID will continue to support NGOs and community groups by developing their capacity to provide patient education trainings, health care monitoring and management of maternal and child health, Tuberculosis and reproductive health.

Maternal and Child Health, Reproductive Health and Family Planning: USAID will provide technical assistance to support high-impact maternal and child health and reproductive health and family planning interventions in Armenia, focusing on reduction of maternal and under-five mortality by establishing an effective continuum of care to deliver essential services for mothers and children at critical points in adolescence, pre-pregnancy, pregnancy, birth, and early childhood.

Tuberculosis: USAID will scale up support to the Ministry of Health and the Armenian National Tuberculosis Program to promote nationwide TB coordination, improve the quality of TB diagnostic and treatment services through the PHC system targeting rural vulnerable populations.