Armenia
Home to one of the world’s oldest civilizations, Armenia is a small country with a beautiful but stark mountainous landscape. From the Silk Road to the post-Soviet era, Armenia’s people have maintained a unique culture and a strong religious tradition. Today, as Armenians strive to claim a place as an industrialized nation, they are working hard to improve primary health care and family medicine.
Armenia’s Soviet-controlled health care system focused strongly on city-based hospital care. As a result services were unavailable to large portions of the population and rural providers lacked necessary skills. The government of Armenia has committed to improving its people’s health by providing nation-wide primary care services at the community level.
Since 2001, IntraHealth has worked in Armenia to support Armenia’s leaders in drafting and implementing better family planning and child health care policies, improve the quality of services, and help hospitals and clinics manage and supervise employees. IntraHealth works with the Ministry of Health and local partners to make high-quality health care more available beyond the major cities. We train rural health care providers in family medicine and community outreach to help people learn about and use the new health care resources.
IntraHealth’s current activities in Armenia help to improve clinical training, curriculum development, quality improvement, human resources management, policy support, and evaluation for health care workers. We are also assisting Armenia in developing and increasing the use of decentralized health care services.
Through Project NOVA, IntraHealth is currently working in five of the country's ten administrative units (marzes)—Syunik, Vayots Dzor, Aragatsotn, Armavir and Ararat—to increase the use of appropriate and safe reproductive health/family planning, and maternal and child health services and practices in rural areas of Armenia. This work includes:
- improving performance of healthcare workers, including pre and in-services training and quality assurance activities, provision of basic clinical equipment & supplies, and renovating healthcare facilities,
- contributing to the formulation of national policy and standards, and
- mobilizing and educating rural communities.
Since October 2004 IntraHealth has trained 180 nurses and midwives in safe motherhood clinical skills, distributed basic equipment and supplies to 263 rural health posts and set up 18 clinical training sites. In addition, more than 1,600 obstetricians/ gynecologists, pediatricians, anesthesiologists, family doctors, venerologists, nurses, and midwives have been trained in key maternal and child health areas, including antenatal care, postpartum care, emergency obstetric care, newborn/ infant care, infection prevention, reproductive health, family planning, STI management, and quality assurance. Over 3,100 health talks were conducted in selec,t project-supported provinces reaching out almost 18,000 people living in rural far-to-reach areas.
IntraHealth is also a partner in the Primary Health Care Reform Project (PHCR), which began in 2005. IH’s role is to strengthen family medicine (FM) and quality of care (QoC). The primary objectives in strengthening FM are to: provide policy support to the Ministry of Health (MOH) in achieving acceptance of FM as the priority primary health care model in the country; support the establishment of new FM practices nationwide; develop up-to-date clinical standards and job-aids for FM providers; and introduce up-to-date curricula and training materials for continuous FM/Family Nursing (FN) education. IntraHealth’s role includes training stakeholders on the Learning for Performance approach so they can create their own training modules. IntraHealth also provides evidenced-based clinical skills teaching to trainers from five regional nursing colleges and trains physicians and nurses in FM and community nursing. We have provided updated medical literature and software to medical schools, FM/FN faculties and clinical training sites. During 2008 the project will continue training family physicians, community nurses and training site clinical preceptors. IntraHealth will also focus its efforts on QoC by finalizing the quality assurance strategy and training curriculum to be rolled out over the remainder of the project. This strategy includes providing technical assistance to the MOH in establishing a framework for QoC policies and activities implementation. By the end of the project IntraHealth expects to train 150 primary health care/family physicians and 460 primary health care/community nurses, establish or strengthen clinical training sites and institutions, assist in strengthening family medicine policy, and build the capacity of the MOH to independently manage the nationwide QoC initiative.
Donors/Projects: USAID (Project NOVA and the PHCR Project)
Partners: Emerging Markets Group, Ltd (lead partner on Project NOVA and the PHCR Project). Save the Children also partners on Project NOVA.
Selected health statistics for Armenia (WHO, accessed July 2008):
Life expectancy, in years (m/f): 65, 72
Probability of dying under 5 years of age (per 100 live births): 24
Adult prevalence of HIV/AIDS: 0.1–1.02%
Maternal mortality (per 100,000 live births): 55
Photos: Igor Dashevskiy