On May 15, USAID HS-STAR project, in collaboration with the Ministry of Health, organized a round-table discussion on the “Public Private Partnership (PPP) promotion in Armenian healthcare” with the participation of MOH and private sector representatives. Banking, telecommunications, mining companies’ and retail trade networks’ directors, marketing, PR and CSR specialists participated in the discussion. PPP is widely practiced in the developed countries of the world, and MOH gives high priority to the introduction of the PPP practice into the Armenian reality.

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The Ministry of Health of Armenia, in the framework of its “clinical standardization initiative”, highly appreciates the role of Republican Scientific Medical Library’s (RSML) newly established evidence-based medicine (EBM) center in assuring the EBM based quality of clinical standards. The recently formed center provides technical and methodological support to MOH clinical standard  development working groups to obtain EBM based information. USAID HS-STAR project also tangibly contributes to this initiative. Particularly, in response to RSML request, HS-STAR provided the center with computers and EBM related 22 books in Russian. Earlier, the project had assured RSML’s subscription to Cochraine online library. Thanks to this action, numerous users of the library are able to access and use the wide opportunities of this worldwide scientific medical network.

It is also envisaged to conduct trainings, workshops and seminars at the EBM center. RSML director Anna Shirinyan clarifies: “The goal of the center is not only to provide relevant materials- books, journals, catalogues, but also to organize specific courses, which will introduce their participant to EBM principles.” On May 8, the donation ceremony of computer equipment to RSML took place. After the event, a working group, formed to develop public education materials and protocols on “cardiovascular diseases and diabetes risk assessment and management” for healthcare specialists, held its regular meeting at the center. HS-STAR project will continue to provide comprehensive support to the Republican Scientific Medical Library and its EBM center.

An evidence based medicine center has been established recently at MOH Republican Scientific Medical Library, which is to assure the EBM based quality of clinical guidelines. In response to RSML request, HS-STAR project provided the center with computer sets and EDM 22 books in Russian: Earlier, the project had assured RSML’s subscription to Cochraine online library.

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USAID HS-STAR project in collaboration with Yerevan State Medical University started a series of 5-day trainings on “Prevention of non-communicable diseases and management of cardiovascular diseases” in May, 2012. It is planned to have ten training courses at 10 Yerevan primary healthcare facilities. Overall, 150 providers: family doctors, cardiologists and general practitioners will participate in the trainings. The courses aim to improve NCD prevention, early detection processes at PHC facilities, and foster the management of NCD processes based on contemporary evidence based medicine principles. YSMU professors will lead the seminars. All trainers have taken adult learning methodology courses organized by HS-STAR project.

The trainings will have interactive nature employing situation analyses tests, discussions and group works along with providing theoretical knowledge. Medical chart reviews on focused topics will be carried out before and after each training course to assess the physicians’ performance before the training courses and assess post training knowledge and their practical application. The first 5-day training course took place at Yerevan N8 Polyclinics and ended on May 8. Fifteen providers of this facility participated in these courses. The trainees were quite delighted with the content of the courses and methods of their conducting. “It was very comprehensive 5-day training, – clarifies Marina Lalayan, N8 Polyclinics general practitioner,- particularly, the exchange of ideas and group discussions were quite useful. We’ll apply this knowledge, received from the best specialists of this arena, into our routine practice.” Stay tuned for more news about the trainings implemented with support from the project.

USAID HS-STAR project started a series of trainings on a number of actual Issues in maternal and reproductive health from April, 2012. The first training course on the basics of preconception care basics took place in “Saint Grigor Lusavorich” medical center on April 26. The aim of these trainings is improvement of knowledge and technical competencies of physicians enabling them to offer safer and high quality maternal and reproductive health care services.  Around 250 providers from selected primary health care (PHC) facilities and maternity hospitals in Yerevan will participate in these trainings. The focuses of the above courses are preconception health care, basics of counseling in reproductive Health/Family Planning and basics of care during childbirth and early postpartum period. Selected faculty members from Yerevan State Medical University (YSMU) will be acting as trainers for the above training courses.

Medical chart reviews on focused topics  will be carried out before and after each  training course to assess the physicians’  actual performance before and after each training course and assure   post training endorsement  of relevant skills into routine practices.  Moreover, during trainings the pre and post training knowledge tests will evaluate the trainees’ received knowledge. Particularly, the knowledge testing during the first training on Preconception Care principles showed quite high results. “According to the pretest results the participants’ knowledge scored аt 63%. The posttest results recorded dramatic increase in participants’ knowledge: up to 99%,” gladly clarified HS-STAR’s MCH/RH advisor Gohar Panajyan. The MCH/RH trainings in Yerevan will last until late July-early August, each week taking place in a different medical center. Stay tuned for more news about the trainings implemented with support from the project.

In 2012, the Family Medicine Independent Practicioners (FMIP) institution will function in Armenia. Currently, the introduction of five family medicine practices in underway, from which two are collective and three individual practices. USAID HS-STAR project directly supports all formation processes of three independent practitioners. Moreover, HS-STAR project is also to provide all five entities with continuous methodological, advisory and educational backing both at their establishment phase and during their full-scale activities.

In this context, on April 21 the first seminar took place marking the launch of the training courses on management, financial management, financial accounting, expenditures accounting and other relevant and important themes for five FMIIPs doctors. The seminar-courses will be held once or twice a month and will last until October. An expert in each arena will lead the corresponding seminar.  Seven family doctors will participate in these trainings. HS-STAR also envisages conducting trainings for these FMIIPs’ accountants and nurses in the future. “Newly established family doctors lack the experience, necessary knowledge and skills of running an independent business entity, and our trainings aim to make them FMIP skilled managers- administrators and organizers,” clarifies HS-STAR advisor Garnik Harutyunyan.

The project has already provided the trainees with necessary educational packages- medical and administrative methodological guidelines and books. During the first training course broader and introductory topics were discussed, namely the health system structure, current legislation, licensing and state order application procedures. The topics for the next seminars were identified and assessed after discussions with participants. These themes will address the practical issues and challenges, which the FMIPs will face at particular stages of their activities. Stay tuned to our project news to get further updates on the next steps and achievements of FMIP introduction process.

On April 10, at “Saint Grigor Lusavorich” medical center Yerevan State Medical University Emergency and Disaster Medicine department initiated a workshop-discussion on “Pre-hospital emergency care models in world developed countries” with the participation of Armenia’s leading specialists in this arena. The workshop was a continuation of a series of discussions organized by USAID HS-STAR project on emergency care situation improvement in Armenia, and aimed at informing the participants about the emergency care systems in world-developed countries and their experience, and at pondering over possible application of some elements into our system.   “Saint Grigor Lusavorich” medical center director, YSMU department head, professor Ara Minasyan conducted the meeting.

Mr. Minasyan introduced the participants to the United States emergency care system, its peculiarities and progress. Afterwards, the pre-hospital emergency care systems and their reforms in the European countries were presented.  Lively discussions followed the presentations, where the participants discussed the situation of emergency care in Armenia, implemented reforms, further improvement ways and strategies. Participants also emphasized the need of forming a professional association. The association will reveal the current problems in Emergency system and will consistently address those issues.

Behavior Change Communication (BCC) is a systematic approach that draws on social science, adult learning theory, and marketing to encourage adoption of sustained behaviors that can be used to prevent or mitigate disease. Anti-tobacco posters that aim to discourage women from smoking are an example of BCC. To improve BCC efforts in Armenia, the USAID HS-STAR project organized two-day training on BCC for Ministry of Health (MOH) public education officials on March 31-April 1, 2012 in Tsakhkadzor, Armenia. Representatives from the MOH Public Relations and Public Health Education departments, the State Hygienic Anti-Epidemiological Inspectorate (SHAI) regional centers, and SHAI regional center public health departments participated in the course. The aim of this introductory training course was to provide participants with sufficient knowledge about BCC approaches and tools to manage the implementation of public education strategies and activities.

Gael O’Sullivan, the Senior Technical Advisor for BCC from Abt Associates’ headquarters, led the training with support from HS-STAR’s Civil Society Engagement team. During the two-day course, Mrs. O’Sullivan introduced the participants to BCC theories, provided an overview of the main principles of BCC, and explained the key steps for proper design and implementation of a BCC strategy. Mrs. O’Sullivan presented the information through a combination of lecture, case studies, group discussion, and role play. Thanks to the interactive nature of the training, the participants had many opportunities to ask questions and propose recommendations for applying BCC approaches and activities to the Armenian context.

Many of the participants found the training to be very relevant for their work. Armine Andryan, MOH SHAI Shirak regional center public education department head, explained how she and her colleagues would change their approach to public education as a result of the training: “Before, we used to implement all our activities without any coherent methodology. We didn’t identify our audience, our goal, or our action plan, and we didn’t evaluate our results. Now that we are acquainted with the methodology, we know how to start the process, how to plan it, how to study the characteristics of our audiences, and how to influence them through correctly designed messages.” Similarly, Karine Gevorgyan, MOH SHAI Aragatsotn regional center epidemiologist, commented on how the training would affect her work: “Deployment of the presented methods will enable us to conduct more systematized campaigns and, most importantly, to evaluate their results.”

The HS-STAR project urged the trained specialists to apply the knowledge they obtained at the training by developing public education projects for their marzes and involving local NGOs, which can play an important role both in finding financial resources for projects and in implementing planned campaigns. The participants stressed that these kinds of trainings should be continuous. The HS-STAR project will continue to provide comprehensive methodological support to MOH entities involved in public education methodology, resource allocation, project and campaign implementation, and strategy development.

On April 4, 2012, USAID HS-STAR project representatives awarded certificates to 26 medical and administrative staff from Yerevan “Ambulance” CJSC who completed an emergency care IT training. This event marked the completion of the first stage of the trainings for the emergency care staff, which aimed to improve their existing computer skills, provide them with the computer skills needed to operate the new dispatcher automated system, and prepare them for the upcoming system. Overall, 30 administrative employees and 78 dispatchers from Yerevan “Ambulance” CJSC participated in these training courses conducted by “CHS Verisel Service,” an organization hired by HS-STAR. According to trainings coordinator Heriknaz Archunts, “During this first stage of the trainings, the trainees learned general computer skills, particularly fast touch typing skills, which are essential for emergency staff.” The second stage of trainings, which will start immediately after the development of the emergency care software packages, will teach the dispatchers how to use the software.

During the awards ceremony, the director of “Ambulance” CJSC Taguhi Stepanyan stressed the importance of the automatized system installation throughout her organization: “All modern approaches used by the emergency care service are based on automatic information exchange and improved communication systems. Currently, the Yerevan emergency service is equipped with a GPS system, computers and relevant software. Moreover, we plan to install automated systems in all services and functions of our company departments. That is why we pay tremendous attention to enhancing the computer skills of our dispatchers. They will be able to handle each call much faster: quickly registering the call, seeing the current location of our ambulances on the monitor, and immediately sending out the nearest ambulance.”

The trainees were pleased with the course results and eager to apply their knowledge at work. “For decades, the dispatchers in emergency care service have worked with pen and paper. Now, we are able to use modern techniques, such as taking the calls through computers, and perform our work much faster. Through this training we realized that registering a call, which takes at least 2-3 minutes to do manually, can now be done in a matter of seconds, thereby saving vital minutes,” gladly noted Hripsime Amirkhanyan, “Ambulance” CJSC N5 substation dispatcher. Gayane Darbinyan, N5 substation dispatcher, commented on the quality of the training: “Overall, the courses were provided quite professionally, and were very useful for our professional development and enhancement of our computer skills.”

The USAID HS-STAR project supports the Ministry of Health (MOH) in the process of modernizing the emergency care service in Armenia through the provision of equipment, technical assistance, and capacity building. In 2012, HS-STAR will work closely with the MOH to introduce a new automated dispatcher system and create emergency dispatcher centers first in Yerevan and then in the marzes. The centers will be equipped with special dispatcher computer software and modern technologies corresponding to high international standards. At the end of the whole process, the Armenian emergency service will function according to the standards of Western counterparts. Stay tuned for more news about the project’s upcoming support to the modernization process of the Armenian emergency care system.

Abt Associates Inc. International Newsletter January-March, 2012 issue has highlighted the process of HS-STAR support to modified MIDAS system installation all over Armenia. Thanks to the initiative of the Ministry of Health (MoH) State Health Agency (SHA) and support from the USAID HS-STAR project, the updated version of the MIDAS-3 automated information system was recently installed in all Primary Health Care (PHC) facilities of Armenia. The overall purpose of the MIDAS system is to improve the efficiency of healthcare service organization, management, quality improvement and financing in Armenian health institutions through better health information.

You may read the article in the 4th page of the newsletter attached below:

Q4 FY12 newsletter_English