1. 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

2. 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

3. 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)

4. Activities of PHC EG 2009 (1)
Application for EU-funded PHC project ”ImPrim” submitted to BSR Programme 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

5. 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

6. 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.

7. 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

8. 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

9. 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

10. 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

11. 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

12. 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

13. 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

14. 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