In one way or another, the PHC reform embraces activities from all the other components of the Project. It builds extensively on the accomplishments of the USAID funded Armenia Social Transition Program (ASTP), which assisted the Armenian Government in developing and pilot-testing basic package of healthcare reforms, including shift to a family medicine focus, introduction of the open enrollment concept in selected locations, improvement of workforce planning mechanisms, optimization of healthcare resource allocation at both national and facility levels.
The objective of the Project now is to expand the agreed upon reforms nationwide reaching even the most remote rural areas. Among the outcomes sought are:
- • Increased service utilization, clinical care, and client satisfaction at target facilities;
• Supportive policy and regulatory framework for implementation of reforms;
• Efficient workforce planning and incentive mechanisms in place to attract PHC providers to rural areas;
• Improved management, supervision and financial oversight mechanisms at the facility level;
• Approximately 230 PHC facilities renovated and equipped for medical purposes.
For each outcome, implementation efforts are focused at the appropriate level:
- • National and marz level: legal and policy framework, open enrollment, workforce planning, budgeting, National Health Accounts, health provider education systems, quality assurance, health information systems)
• Facility level: management, finance and accounting, clinical care, quality improvement, infrastructure improvements, health information systems
• Community level: health seeking behavior, NGO capacity building and small grants, community mobilization.
Policy Support and Stakeholder Buy-In
The Project relies strongly upon cooperation from the Ministry of Health, the Ministry of Finance and Economy, State Health Agency, and other key institutional and individual stakeholders. The Project team currently works with the Government to have the priorities and the overall approach to the PHC reform in Armenia refined further and translated into legislative acts. This will help ensure that the Project’s inputs and improvements will be supported and maintained.
Facility Renovation and Upgrades
In support of healthcare reform efforts, the Project has started the selection of PHC facilities (polyclinics, ambulatories and FAPs) for renovation and upgrading with computer and medical equipment. Facility selection criteria are based on a range of indicators, including number of population in the area, accessibility of care, infrastructure needs, coverage by other USAID and donor organization funded projects currently or in the past. Improvements achieved will be assessed as part of the Project’s evaluation activity.