NDPHS EXPERT GROUP ON PRIMARY HEALTH CARE Carl-Eric Thors Chairmen, PHC EG Arnoldas Jurgutis ITA, PHC EG

PHC EG – role and objectives Promote general awareness concerning the role and significans of comprehensive community oriented primary health care as one of the cornerstones of a well –functioning health care system Objective of ND PHS work: improved public health through developing primary health care services, responding appropriately and equally to the needs of the people

Improved public health for all groups of the whole population Effectively functioning NDPHS PHC EG capable to produce added value to the PHC development of the ND region Improved public health for all groups of the whole population Developing quality primary health care and social service provision in all ND countries Improved health of the population in cost effective ways Functioning health promotion mechanisms Reduction of the spread of communicable diseases Prevention of non-communicable diseases Promotion of healthy life-styles Improved public health through developing primary health and social care services, responding appropriately and equally to the needs of the people, as part of the health care systems 1.1. Functioning meeting procedures 1.2. Ensure horizontal collaboration with other EGs 1.3. Recruitment and working arrangements of the ITAs 1.4. Reporting to and participation in NDPHS 1.5. Strengthening the role and visibility of the EG in PCH development between the ND Countries Project proposals to be developed according to the suggestions from thematic reports 2.1. Collection of information for and compilation of thematic reports 2.1.1. Collecting and aggregating information from PHC 2.1.2. Role of PHC in health promotion and disease prevention 2.1.3. Implications of demographic changes for PHC 2.1.4. Information sharing about remuneration systems for PHC and their implications 2.2. Carrying out situation analysis 2.3. Dissemination of information 2.4. Policy analysis and reports Working Area 1 Framework for PHC EG functions Working Area 2 Production of thematic reports and situation analysis Working Area 3 Support to planning, implementation and monitoring of projects Working Area 4 PHC EG contribution to database and project pipeline activities as cross-cutting principles 4.1. Development of the database as a tool 4.2. Creation and use of the project pipeline “as a marketplace” or “project preparation platform” 4.3. Production of information on geographical areas 4.4. Encouragement of stakeholders to create projects Elements of functioning PHC EG of the NDPHS

PHC EG Partner representatives Estonia Finland Latvia Lithuania Norway Poland(Co leadpartner) Russia Sweden (lead partner) WHO/Euro

Producing thematic reports: Situation of PHC in Northern Dimension region and the different remuneration systems of PHC and their implications Role of PHC in health promotion and disease prevention in the ND region Implications of demographic changes for PHC

Report on the situation situation of PHC in Northern Dimension region Main objective of the comparative report on the primary care in the ND Countries is to describe situation of primary health care emphasising possible gaps, differences and to provide support for planning, implementation and monitoring of the projects or other initiatives that contribute to the development of Primary Health Care in the Northern Dimension Region

Gaps in the primary care systems in ND Countries&Recommendations for project-based activities There is an evident gap in the requirements for professional training of the primary care doctors and nurses The ND Countries show big variations in the activities of the primary care nurses and doctors

Gaps in the primary care systems in ND Countries&Recommendations for project-based activities The last two decades are considered to have brought a certain breakthrough in the role of the primary care doctors and nurses for the professional advice on life style issues The educational activities on proper motivational counselling on smoking cessation, cutting down alcohol, healthy lifstyle would be very important

Gaps in the primary care systems in ND Countries&Recommendations for project-based activities Partnerships countries would benefit when finding the balance between the needs of the patients and the communities and effective work of the primary care system Payment schemes with the incentives to increase health promotion and disease prevention activities would be very relevant for most the ND Countries. Sharing of the experiences in this field and lessons learnt from the mistakes would be appreciated by the majority of the health care decision makers of the ND Countries

Gaps in the primary care systems in ND Countries&Recommendations for project-based activities More equitable and adequate to real needs accessibility to secondary health care resources should be guaranteed for all population in Northern Dimension Countries New strategies are needed, especially in North East countries to improve cooperation between primary health care and secondary health care Population with several chronic conditions (high morbidity) are high users of health care resources, so guidelines of care of population with high co-morbidity (2% of patients with high or very high morbidity consume about 30% of HC)

Gaps in the primary care systems in ND Countries&Recommendations for project-based activities Quality improvement tools differ evidently in Baltic States, Russia, Belarus when compare with Nordic countries Internal audit tools based on the demand for improvement of personal performance motivate primary care staff to act better without fear of being externally controlled

Gaps in the primary care systems in ND Countries&Recommendations for project-based activities Appropriate strategies needed in all Northern Dimension Countries for empowerment of the community and other sectors to play active role in community health need assessment and solving of priority problems Primary health care team should play active role in shifting responsibility for health from medical professional towards community (Very actual in North East Countries)

Gaps in the primary care systems in ND Countries&Recommendations for project-based activities Other: Home care and care of the elderly IT technologies in the primary care research in primary care

Future work PHC EG is planning to initiate a discussion on the long term development of primary health care in the ND region PHC EG meeting May 22, Vilnius Seminar on PHC situation in NDP Countries Project based activities developed and implemented by EG members involving relevant stakeholders

Seminar on PHC situation in Norhern Dimension Countries May 23rd, Vilnius Jointly organised Swedish MoH&SA Lithuanian MoH and WHO Regional office for Europe

Seminar on PHC situation in Norhern Dimension Countries Objectives of the seminar: to present evidence from international research data on the importance of primary health care (PHC) in modern society for cost-effective and equitable health care system to introduce recent WHO activities for strengthening primary health care in the region to present and to discuss the situation of PHC and to agree on priority strategies for strengthening PHC in the Northern Dimension (ND) countries

Seminar on PHC situation in Norhern Dimension Countries Key speaker: Prof. Barbara Starfield, Bloomberg School of Public Health, Johns Hopkins University , USA: “Role of Primary Health Care in Modern Societies” Better health outcomes Lower costs Greater equity in health

Primary Care Orientation of Health Systems: Rating Criteria Practice Characteristics First-contact Longitudinality Comprehensiveness Coordination Family-centeredness Community orientation Health System Characteristics Type of system & Financing Type of primary care practitioner Cost sharing for primary care services Patient lists

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