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

2. 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

3. 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
Collecting and aggregating
information from PHC
Role of PHC in health
promotion and disease prevention
Implications of demographic
changes for PHC
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

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

5. 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

6. 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

7. 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

8. 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

9. 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

10. 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)

11. 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

12. 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)

13. 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

14. 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

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

16. 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

17. 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

18. 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

19. Thank you!

20. Thank you