Helena Silfverhielm, Chair PPHS EG Arnoldas Jurgutis, ITA PPHS EG NDPHS EXPERT GROUP ON PRIMARY HEALTH AND PRISON HEALTH CARE SYSTEMS Activities to implement goal 4, 5, 6

Goal 4: Resistance to antibiotics is mitigated in the ND area OT 1: By 2012, the existing networks working on the above-mentioned goal are strengthened (steps are also taken to encourage the creation of the efficient surveillance of antimicrobial resistance and antibiotic consumption, with comparability between countries). I: Number of new members added to the existing networks. I: Increase in activity of the existing networks measured by conferences and trainings implemented. OT 2: Series of trainings for professionals are organized, aimed to strengthen their capacity to help mitigate antibiotic resistance. I: Number of trainings successfully implemented, including all of their components.

No meetings during A planned meeting in Oslo was postponed due to low interest to participate from the members combined with financial difficulties for some participants to ensure the necessary funding for coming to the meeting The main activity of the group in 2012 was on developing a project plan and efforts to ensure financial support for a ESBL-study. No funding has been allocated so far Chair (Dr Sven Hoffner, Sweden) and co-chair (Dr Wolfgang Witte, Germany) resigned by the end of 2012 A third meeting of the group will be held in Berlin on April 29 ● A new chair (Dr Karin Tegmark Wisell, Sweden) and co-chair (Germany) will be offered to the group for election ● ToR will be discussed

Goal 5: Inequality in access to qualified primary health care in the ND area is reduced OT 1: Differences in the accessibility of qualified primary healthcare in countries of the ND region are assessed I 1: A report outlining the differences in the accessibility of qualified primary health care in partner countries and recommending further actions is developed. OT 2: Mechanisms for promoting an equitably distributed and good quality primary care, which corresponds to changing society health needs in the region, are defined. I 1: A jointly developed paper presenting population health care needs in the ND region is in place. I 2: A position paper on tomorrow’s role of primary health care professionals in the context of changing society needs is in place. I 3: Jointly developed conclusions for education and professional development of primary health care teams with particular attention to PHC nurses and patient empowerment are in place. I 4: Models of good practices in different countries are demonstrated and policy conclusions for dissemination are in place. OT 3: By 2013, the advantages of e-health technology are better known and appreciated by policy makers and healthcare professionals. I 1: Pilot project on tele- mentoring for career development of health professionals in remote primary health care. I 2: Pilot Project on tele- consultation for improved Professional cooperation and quality in remote primary health care. OT 4: By 2013 a review of policies and practices for primary health care services for migrants will be presented and disseminated to inform and mobilize ND States and other stakeholders on migrant health issues I 1: A report on policies and practices for primary health services for migrants developed and disseminated I 2: Consultations in/within the ND Region held and a workshop organized

Goal 5: Inequality in access to qualified primary health care in the ND area is reduced OT 1: Differences in the accessibility assessed I 1: A report on the differences in the accessibility 3 Imprim reports: Funding Primary Health Care in the Baltic Sea Area (Joint Transnational Synthesis report for Imprim Countries) Transnationally valid incentive payment scheme attracting health professionals to PHC and increasing performance of PHC particularly towards disease prevention and health promotion in the community (piloted in the framework of the project) Operational and tested system of evidence-based and recognized quality indicators for PHC performance (piloted in the framework of the project) ( Needs to increase accessibility to vulnerable population groups Survey to assess accessibility to health services for exprisoners and migrants in 2012 Workshop during PPHS EG meeting, September 2012 Initiatives with IOM for the project aimed on deeper situation analysis

Goal 5: Inequality in access to qualified primary health care in the ND area is reduced OT 2: Mechanisms for promoting primary care, which corresponds to changing society health needs I 1: Report on population health care needs in the ND region is in place. I 2: Policy document on tomorrow’s role of primary health care professionals in the context of changing society needs. I 3: Jointly developed conclusions for education and professional development of primary health care teams with particular attention to PHC nurses and patient empowerment are in place. I 4: Models of good practices in different countries are demonstrated and policy conclusions for dissemination are in place. 2 Imprim reports WP4: Strategy for continuous professional development of primary health care professionals in order to better respond to changing health needs of the society Multi-professional teamwork to gain better community health the potential of high quality PHC

Goal 5: Inequality in access to qualified primary health care in the ND area is reduced OT 2: Mechanisms for promoting primary care, which corresponds to changing society health needs I 1: Report on population health care needs in the ND region is in place. I 2: Policy document on tomorrow’s role of primary health care professionals in the context of changing society needs. I 3: Jointly developed conclusions for education and professional development of primary health care teams with particular attention to PHC nurses and patient empowerment are in place. I 4: Models of good practices in different countries are demonstrated and policy conclusions for dissemination are in place. Project proposal : Improvement of competences of PHC nurses and other PHC team members in community based health promotion, prevention and management of NCDs with particular focus on vulnerable population groups and patients with high comorbidity Contribution to ADPY-project on WP Development alcohol and drug prevention cooperation model. Imprim Report WP5: Incorporating PHC in regional development plans. A basis for quality health for all

Goal 5: Inequality in access to qualified primary health care in the ND area is reduced OT 2: Mechanisms for promoting primary care, which corresponds to changing society health needs I 1: A jointly developed paper presenting population health care needs in the ND region is in place. I 2: A position paper on tomorrow’s role of primary health care professionals in the context of changing society needs is in place. I 3: Jointly developed conclusions for education and professional development of primary health care teams with particular attention to PHC nurses and patient empowerment are in place. I 4: Models of good practices in different countries are demonstrated and policy conclusions for dissemination are in place. Activity 3 of NDPHS project funded by DG REGIO: Background material for a project proposal on the future role of local (district, rayon, etc.) hospitals as a structure covering the interface between primary health care and specialist care have been collected in Latvia, Lithuania, Finland, Russia and Belarus Result - Project concept with broaden scope: Integrated care for senior citizens around the Baltic Sea Aim Application to EU BSR seed money are ready to be submitted April 15 th,

Goal 5: Inequality in access to qualified primary health care in the ND area is reduced OT 3: By 2013, the advantages of e-health technology are better known and appreciated by policy makers and healthcare professionals. I 1: Pilot project on tele- mentoring for career development of health professionals in remote primary health care. I 2: Pilot Project on tele- consultation for improved Professional cooperation and quality in remote primary health care. Activities of the Project PrimCare IT (2011 – 2013) eHealth acceptance conference 2012 Nov In Brussels, NDPHS presentation Aigars Miezitis (PPHS EG Latvia) The future of e-Health activities within the NDPHS (PPHS EG 6th Meeting in Druskininkai, Lithuania) Prof. Dr. Roland Trill, eHealth for Regions Network Management Office, Flensburg University of Applied Sciences

Goal 5: Inequality in access to qualified primary health care in the ND area is reduced OT 4: By 2013 a review of policies and practices for primary health care services for migrants will be presented and disseminated to inform and mobilize ND States and other stakeholders. on migrant health issues I 1: A report on policies and practices for primary health services for migrants developed and disseminated I 2: Consultations in/within the ND Region held and a workshop organized Survey to explore existing gaps in ND countries should be performed: accessibility of health services to vulnerable population groups (migrants, ex-prisoners, unemployed, elderly ) appropriatness /existance of migrant sensitive /of health related services and policies Application to the Swedish Institute seed money together with IOM

Goal 6: Health and other related needs of people kept in places of detention are readily met, access to the health services is improved, and gender specific needs are addressed OT 1: By 2012, through the series of actions organized by international organizations including the WHO Regional Office for Europe’s Health in Prisons Programme, policy guidance on the provision of health care services in the penitentiary system, which are equivalent to the standard available in the general community, are developed. Preliminary assessment of organizational structures of Prison Health services and their influence on access to health care institutions in different Partner countries has been carried out and best practices and challenges are identified. International experiences on Prison Health and examples of evidence-based practice have been disseminated. I 1: Comments are provided to the draft document of WHO guidance on the Stewardship role for Prison Health, and the Expert Group is involved in its dissemination and promotion once ready. I 2: Regional Consultations and participation in WHO Expert Group meetings have been organized. OT 2: By 2013, a documentation of lessons learned and good practices regarding gender- and group-specific health needs in Prisons are shared at national and international seminars. Actions will be undertaken following up to the WHO/UNODC Declaration on Women’s Health and will be implemented in close collaboration with WHO Regional Office for Europe’s Health in Prisons Programme. I 1: WHO/UNODC Checklists on Women’s Health in Prison introduced and promoted, and piloting in some countries organized. I 2: Successful compilation and completion of the documentation and distribution among the relevant professionals in the ND area OT 3: By 2013 a review of policies and practices for health services for migrants kept in places of detention will be presented and disseminated to inform and mobilize ND States and other stakeholders on migrant health issues I 1: A report on policies and practices on health services for migrants kept in places of detention developed and disseminated I 2: Consultations in/within the ND Region held and a workshop organized

Since July 2013 ITA for prison health issues is not contracted any more Activities are limited to OT3 - a review of policies and practices for health services for migrants kept in places of detention will be presented and disseminated to inform and mobilize ND States and other stakeholders on migrant health issues Application to SI seed money in cooperation with IOM New agreement between Norway and Russia in the field of prison health (train leaders in prison health etc) Ideas to introduce PHC indicators in prison health field – learn from Imprim results and adapt selected indicators Concerns about the participation of prison health experts from East European countries Separate prison health expert group in the future