NDPHS EXPERT GROUP ON PRIMARY HEALTH CARE Activities since April 2009 Göran Carlsson, Chair Arnoldas Jurgutis, ITA NDPHS Primary Health Care Expert Group NDPHS CSR Meeting, October 15-16, 2009, Riga

Overall objectives of ND PHC EG work: ToR of PHC EG Overall objectives of ND PHC EG work: support efforts towards the improvement of health systems and health sector reforms enhance policies on political agendas that emphasize the role of primary health care in health systems promote networking and partnership building among relevant stakeholders I added here costefective

PHC EG Partner representatives Belarus (since October 2008) Estonia Finland Latvia Lithuania Norway Poland (co-lead partner) Russia Sweden (lead partner) WHO/Euro (participation in selected meetings) Thanks to Seniour representatives should be given (Russia, Baltic Countries, Sweden)

Activities of PHC EG 2009 (1) Application for EU-funded PHC project ”ImPrim” 2010-12 submitted to BSR Programme 2007-2013 in March 2009 ImPrim project approved September 2009 Input to SWG on strategic issues and on NDPHS MTGs submitted Chair participated in visit of SWG Chair and Head of Secretariat to WHO Euro and to NCM, Copenhagen

Activities of PHC EG 2009 (2) PHC EG meeting in Minsk September 10-11 Satelite Workshop on PHC development in Belarus (Sept 10) Preparations for EG contributions to Prison Health side event at PAC in Oslo, November 2009 Main contribution by Finnish member Simmo Kokko 5

PHC EG 8th Meeting in Minsk September 10-11 Workshop with WHO Euro and Belarus MoH: PHC reform in Belarus - achievements and constraints Extensive discussions on NDPHS Goals and Targets in relation to Expert Groups tasks Discussions on the structure and specific objectives of the Position Paper – first of several position papers to include practical conclusions on PHC options for NDPHS Countries to address future health systems challenges Possibilities for project proposals and project funding in line with PHC EG objectives.

Objectives of ImPrim project ImPrim Project: “Improvement of public health by promotion of equitably distributed high quality primary health care systems” Objectives of ImPrim project Promote the equitable distribution of high quality primary health care services in the BSR Increase cost-efficiency of the public health system and efficiently counteract communicable diseases as well as health problems related to social factors Should be tald links with other EG

Expected ”ImPrim” project outcomes Policy instruments for increasing overall PHC resources identified Mechanisms for equitable distribution of PHC services developed Models to improve performance of PHC professionals in addressing health risks related to social factors and counteracting communicable diseases tested Strategies and tools for improving quality of PHC services recommended Should be tald links with other EG 8

14 partners from 8 countries (BY , EE, LV, LT, EE, PL, SE, FI) Partners involved 14 partners from 8 countries (BY , EE, LV, LT, EE, PL, SE, FI) 5 MoH as associated partners (BY, LV, LT, SE, FI) Attemps to mitigate effects of non-signing of ENPI Financial Agreement by EU and Russian Federation Two associated partners from Russia (MoH of Kaliningrad oblast and Central Research Institute of Health Organization and Informatization ) External funds for joint ImPrim-Russia activities will be applied for Should be tald links with other EG 9

Current ImPrim activities Contractual process with Joint Technical Secretariat – contract clarifications, linking up with ICT for Health Establishing Lead Partner management office Procurement of external services Grant contract for some 2.2 mEuro to be signed Activities to start within 3 mo of approval – Dec 16 Kick-off meeting Jan or Feb 2010

Other projects NDPHS Pipeline project ID 14: Establishing EBM and developing Quality of Care in PHC through extended networks of PHC doctors and nurses in Northwest Russia Main project donor is the Ministry of Health, Finland implemented by Blekinge Centre of Competence (Dr Ingvar Ovhed) with Murmansk, Archangelsk, St. Petersburg, Pskov and Kaliningrad. Initiated by PHC EG and applying (second time) for Norwegian Funds Improving utilisation of PHC services in Kaliningrad region through reduction of unjustified referrals to secondary health services Increase of the share of resources for PHC institutions in pilot region of Kaliningrad

Activities initiated by PHC EG to address ad hoc needs Seminar on Implementation of private independent contractors in Lithuania, for Kaliningrad MoH and regional health administrators, Klaipeda, April 30th, following expressed needs during PHC EG Meeting in Kaliningrad; implemented by Swedish, Lithuanian members PHC EG Workshop on Tomorrow´s role of Family Doctors and Nurses, at Baltic Conference of Family Medicine, Piarnu, Estonia Initiated by Finnish and Norwegian experts Paula Vainiomaki and Toralf Hasvold Input for the PHC EG position paper collected

Essential issues related to CSR decisions on Goals and Targets Reality check for Partnership targets versus Expert Group set-up ToR and structure for Expert Groups Internal EG discussions on how to contribute to Partnership Goals – CSR governance vs EG autonomy 13

Future challenges for PHC in health systems Demographic changes Changing disease panorama Complex and co-morbid patients Team work within health care and social services Patient roles active, participatory New technologies – preventive, diagnostic, therapeutic and rehabilitative Information overflow – to adequately select rather than to produce more The knowledge base - from experienced based to evidence based Increasing gap between expectations and resources New teaching arenas