Family medicine was introduced in Armenia in 1999, through the Family Medicine Statement issued by the Ministry of Health of the Republic of Armenia (MOH). Since then, owing to policy and systemic reform efforts, regulatory framework for family medicine (FM) was put in place, and the concept has become more widely understood throughout the country. In 2003, Unified Family Medicine Curriculum was introduced, and a large number of primary health care (PHC) providers have undergone training and are now qualified to practice as certified family physicians.
At the same time, the further development of FM in Armenia faces a number of challenges, including lack of clinical protocols and standards, limited financing and lack of incentives, insufficient number of family medicine practices, limited training and re-training opportunities and capacity, poor public perception.
The PHCR Project’s primary objectives in strengthening the FM are to:
• provide policy support to the MOH in achieving acceptance of FM as the priority PHC model in the country;
• introduce FM practice models; support the establishment of new FM practices nationwide;
• develop up-to-date clinical standards, guidelines and job-aids for FM providers;
• introduce up-to-date curricula and training materials for continuous FM and FN education;
• provide quality training and re-training to 150 family physicians and 670 family nurses.
Countrywide public education campaign to promote and raise public awareness of FM and its benefits for the population will also be implemented. The Project will build upon the accomplishments of the Armenia Social Transition Program (ASTP), a five-year USAID funded activity ended in October 2005, which contributed extensively in the initial phases of FM introduction in Armenia. The Project also draws on the experience of other ongoing health care activities such as USAID funded Project NOVA.
FM Policy Support
To further enhance the recognition of the FM and the FM practice in Armenia, the following solutions were elaborated and are currently pursued by the PHCR Project in cooperation with the MOH:
| Incentives to Providers to Become Family Physicians and Nurses: The Project works with the MOH to introduce performance-based payment mechanisms for providers of PHC services. Besides, given the existing demand for FM and FN practitioners in distant rural areas, the Project also explores ways to have incentives (financial and non-financial, such as housing, facility upgrades and access to training) put in place for family physicians to establish practices in such locations. |
| Expanded Scopes of Practice of Family Physicians: The Project provides technical assistance to stakeholders in conveying the importance and benefits of having PHC physicians assume greater scope of practice and responsibility. This will also promote the recognition of FM as the foundation of the PHC system. |
| Expanded Role of Community Nurses: In 2005 the MOH issued Family Nurse Statement, which set out the basic framework for FN activities in Armenia. Still, the concept of family / community nurse has not yet been institutionalized and widely accepted. Given that especially in rural areas nurses serve a critical primary care and health education function, the Project currently works in partnership with the MOH, nurse training institutions and Project NOVA to further elaborate the concept, define the exact roles and education level required for a family/community nurse. |
FM Practices
In cooperation with the MOH and the World Bank the PHCR Project will conduct feasibility study for various FM practice models (polyclinic practices, rural FM practice, private free standing FM practice) to determine the most workable and efficient model for Armenia. Government decree to regulate the establishment and activities of FM practices has been drafted and will be refined further.
The Project will assist the FM practices established according to the decree in acquiring legal status, strategic and human resource planning, finance and accounting, costing/pricing, market assessments, marketing of services, and advertising. Management training will also be provided.
Continuous FM Education and Clinical Training
The Project works to improve FM and FN practitioners’ access to quality post-graduate education and training opportunities. For a detailed coverage of the PHCR Project activities in this area please refer to the Clinical Training section of our website.