Community Based Primary Health Care Programme

The Programme Aim

To support PHC services' improvement in Borderline, Refugee and Poverty stricken rural communities of Armenia, making it accessible for the most vulnerable groups, by community participation ensuring its sustainability.

This Program has been piloted and set up in Refugee villages of Vayots Dzor and Syunik Regions of Armenia in 1995, by the public health team of Oxfam GB Armenian. Later in 2000 Oxfam Public Health Team evolved from it and established a local NGO called “Support to Communities”. Since then until now the program implementation has been transferred and implemented by STC. In 2003 STC has established the healthcare foundations and the Program implementation has been handed over to Foundations.

STC is the founder and the Trusted Manager of Foundations and continuously supports and assist them in implementation of projects.

In 2004 as a successful Program it has been replicated by WV Armenia.The programme was called "Mobile Outreach Team Program funded by USAID and WV". STC in cooperation with WV has expanded Program activities to the Northern regions of Armenia, (Lori, Tavush and Gegharquniq) as well as in Syunik. The number of project villages was increased.

So far, STC in close cooperation of three Healthcare Foundations is implementing health program in 140 villages in five regions of Armenia, Vayots Dzor, Syunik, Lori, Tavush and Gekharqunik, benefitting more than 85,000 people.

These are the main activities of the Program

1. Selection of villages:
   For the selection of villages we have taken into consideration the following criteria;
   • Refugee inhabited communities
   • Remoteness of the village from district centers and hospitals
   • Condition of village health post
   • Borderline and isolated villages
   • Willingness of population to contribute and take further responsibility
   • Local authorities consideration and prioritization
   • Absence of other similar projects in the village
2. Establishment of alternative pro-poor health financing replicable scheme in selected villages.
3. Construction, rehabilitation and refurbishment of village Health Units and facilities.
4. Training of health personnel / nurses.
5. Community health promotion and education - USAID/PHCR Program.
6. Establishing and facilitation of Revolving Drug Fund (RDF).
7. In coordination and cooperation with regional health authorities – continuous provision of basic medical supplies and pharmaceuticals.
8. Revolving Drug Funds Committees creation, registration as Healthcare Foundations in Syunik, Vayots Dzor and Northern – involving Lori, Tavush and Gegharqunik Marzes. The created foundations are independent legal entities registered at the Ministry of Justice of RoA. STC is the Founder and Trasted Manager of Health Foundations.
9. Strengthening and capacity building of Foundations.
10. Creation of Mobile Laboratory equipped with Ultrasound Machine, Electro - Cardiograph, Laboratory Test Kits, other supplementary materials.
11. Establishment of Mobile Outreach Teams and organization of narrow specialized doctors’ outreach visits for the identification of the cases and the treatment of village population.
12. STC has set up good working relationship with National, Regional Authorities and Healthcare Institutions (Signed Memorandum of Understanding and Cooperation).

In the framework of Healthcare Program, STC implements also Health Rights Protection project.

The Programme Aim

To increase communities' awareness on their health related issues and rights through behavior change promotion and health right protection in 45 village communities of Vayots Dzor, Lori, Tavush and Syunik regions of Armenia.

The following activities have been conducted to achieve the objectives

1. Selection of 30 village communities, 15 from each region, according to the following criteria:
   • Health Ombudsman component is not implemented in our previous projects
   • Refugee / Borderline village communities
   • Remoteness of the village from ambulatory services
2. Conduction of surveys on:
   • Cases of violation of patient’s health rights during past two years, nature of cases and effect on patient’s health and social status.
   • Awareness of the village population about the state provided PHC program.
3. Presenting/Using survey results on policy-discussions, round-tables with health authorities, meetings with health authorities, as well as for advocacy purposes.
4. Development of 6000 copies of leaflets about the patient’s rights and distribution to the targeted 45 village population, health units and medical posts. The booklets will provide information on health ombudsman, with contacts. Also contacts of civic centers, as well as RA ombudsman office has been included, for those who would prefer applying to higher instances. These booklets were distributed during the community meetings.
5. Setting up a hotline in regions (Yeghegnadzor, Ijevan and Kapan) to ensure that beneficiaries have access to Health Ombudsman and the complaints and rights violation cases are registered and processed accordingly.
6. Conduction of a round table discussion with all stakeholders / regional health authorities, local health institutions representatives, Oxfam, local self-government representatives, community members/ and introduction of the outcome / results of the program.
7. Dissemination of Health promotion as well as health rights protection messages through SMS.
8. Registration of feedback and complains from the beneficiaries and follow up of issues at different level (Community, Region, National).

Healthcare Foundations

Three health Care Foundations were established since 2008, in Vayots Dzor, Syunik, Tavush, Lori and Gegharqunik regions. Primary healthcare Program now is directly implemented by the Foundations.