Primary Healthcare Centers in Various Countries

As a result, people in these regions are becoming healthier, as they make improved lifestyle choices and participate in preventive care. Caregivers also continue to benefit from this approach, as they are able to better apply their knowledge and skills within the Primary Healthcare model, and can assist patients before health problems escalate to health crises.

One of the greatest achievements of the Primary Healthcare partnerships—the improved access to care—has been realized primarily through the establishment of 28 model PHC Centers and an estimated 270 replication care sites.

Additionally, Primary Healthcare Training Centers located at several of these Primary Healthcare Centers have also helped strengthen the primary care initiatives in these regions.

Medical school curricula have been modified in several countries in the region to incorporate an evidence-based approach to general practice in the clinical areas prioritized by the partnership program. Pre-graduate and post-graduate general practitioner residence programs have been set up. Several partner Primary Healthcare facilities became designated clinical teaching sites, and resident rotation schedules were established.

In Moldova, for example, the four-year cycle of post-graduate training brings all rural family doctors to the Botanica District Primary Healthcare Center, set up by an AIHA-sponsored partnership, for training in evidence-based general practice. Students at the SMPU (National Medical University of Moldova) rotate through the affiliated Clinical Training and Skills Testing Center established by the Chisinau/Norfolk, Virginia, partnership. In Kharkiv, Ukraine, the Kharkiv/La Crosse, Wisconsin, partnership has sponsored The City Student Polyclinic that has become a clinical training site for the Family Medicine Program of the Post-graduate Medical Academy. The Siberian Medical University in Russia brings its medical students to Primary Healthcare Centers established in Tomsk Oblast by the Tomsk/Bemidji, Minnesota, partnership.

• 28 model PHC Centers were established according to the integrated model of PHC; an estimated 270 clinics were replicated without partnership funding.
• Two million patient visits occur each year in partnership-sponsored Primary Healthcare Centers;
• 29 community health councils and 37 patient clubs (involving 4,600 members) are functioning;
• 30,000 residents and practitioners trained in primary care practices.

• All model Primary Healthcare clinics meet at least 8 of 10 quality criteria related to counseling, use of clinical evidence, screening services, involvement of nurses, availability of patient education materials, group health education classes, CQI activities, implementation of occupational health and infection control, and community outreach activities;
• Patient surveys conducted in 2002-2003 in 20 model Primary Healthcare Centers have shown:
• On-target level of customer satisfaction (>= 5.8 on a 7-point scale for 22 variables of provider performance) in 6 facilities, and just below the target in 6 more;
• Primary care-to-specialist referral rate has declined from two-thirds to an estimated 20 percent across model Primary Healthcare Centers.

This section contains brief summaries for each of these countries—Albania, Armenia, Azerbaijan, Georgia, Kazakhstan, Moldova, Russia, Turkmenistan and Ukraine—describing the Primary Healthcare Centers that were established and their achievements. Click the links below to access this information.