Primary Health& Prison Health Systems Expert Group

Fourth Meeting

Berlin, Germany

9-10 February 2012

Reference / PPHS 4/10/1
Title / Draft project proposal on behalf of PPHSEG for possible EC support to NDPHSEGsand TGs in 2012 (ENPI Regional East Indicative Programme)
Submitted by / ITA
Summary/Note / This draft project proposal have been developed by PPHSEGITA Arnoldas Jurgutis and primary health care experts Paula Vainiomaki (Finland), Denis Kochkarev (Russia). Project idea have been approved by PPHSEG Chair Helena Silfverhielm and Co-chair YuliaMikhailova and the project proposal have been submitted to .NDPHS.
Requested action / For information to PPHSEG Members and to get more experts interested to participate in the project.

Name of the activity:Improvement of community based health promotion,prevention and management of non-communicable diseases (NCD) through strengthening competences of primary health care (PHC)nurses and other PHCteam members with particular focus on vulnerable population groups.

  1. Short description:

Health systems can better contribute to reduction of premature death and prevent early morbidity, by earlier identification of NCDs and by better and earlier identification of high risk persons,fostering health promotion and modification of risk factorsin the community. Scientific evidence exists that well-organized primary health care teams can apply effective interventions in modifying such NCD risk factors like smoking, risky alcohol consumption, unhealthy diet and low physical activity. Still, such interventions are not sufficiently used in primary health care, family doctors and nurses in ND countries often lack special attitudes and skills on how to apply health promotion models and motivational counseling techniques. Quality of primary health care with regards of NCD prevention and management are unequal when compared between the countries of ND region and inside the countries between different practices. Inequalities also exist when accessibility of health care services for different society groups is compared.
Nurses are in close touch with patients and they have to play a key role in leading and fostering collaboration with other health care professionals, especially with family doctorsand social workers. Nurses may also develop interaction models which would be the best to respond to the NCD related needs of patients.

The project should focus mainly to direct the health service delivery closer to the patients and through extended PHC teams to promote wellbeing and health in the community.

To address burden of chronic diseases, special attention is needed for vulnerable population groups, like migrants, ethnic minorities, ex-prisoners, unemployed, specific vulnerablechildren, elderlyetc., who usually have higher prevalence of NCD risk factors and higher prevalence of NCDs.

Specific results to be achieved:

1.Situation analysis:

  1. describingthe role of PHCteam members, with particular emphasis on the role of the nurse
  2. Identifying evidence based toolsused in primary health care for prevention of main NCD in Sweden, Finland, Lithuania and Russia

2.A position paper on Tomorrow’s role of primary health care professionals in the context of changing society needs is in place.

3.Introducedselected tools for improved prevention and management of NCD in two pilot practices (Russia and Lithuania)

Activities needed to achieve these results:

  1. Site visits to PHC practices and focus group discusssions with primary health team members
  2. Review of existing programmes and curricula for undegraduate and postgraduate training of PHC nurses in all participating countries
  3. Review of existing experiences of interdisciplinary training to foster teamwork in primary health care
  4. Workshops in diferent countries (at least one in Lithuania and one in RF (Kaliningrad)) on role of the nurse and multiprofessional primary health care teams in addressing NCD related needs of vulnerable groups in the community
  1. Implementation time (from – to): April 2012 – May 2013
  1. Actors to be engaged in the implementation:
  1. Russian Federation, coordinating RF partners to be involved – prof. Yulia Mikhailova, PPHS EG vice-chair,Russian Federation)
  2. Institute for R&D, Moscow (?)
  3. Minsitry of Health of Kaliningrad oblast ?
  4. E. Kant University of Kaliningrad ?
  5. Lithuania - Arnoldas Jurgutis, ITA PPHS EG
  6. Klaipeda university ?
  7. Finland – Paula Vainiomaki PPHS EG member, Finland
  8. Turku University of Applied Sciences? under negotiation
  9. Sweden – partners should be defined by NDPHS Senior representative Goran Carlsson (should be agreed AJ) (Sweden)

Experts mentioned on the list and PPHS EG ITA Arnoldas Jurgutis will be responsible for identifying relevant actors in their respective countries.

  1. Preliminary budget calculation:
  2. Experts input per site visits, focus group discussions, report on situation analysis: 7000 Euro
  3. Traveling and accomodation (international and national): 8000 Euro
  4. Costs of the workshops:14 000 Euro
  5. Experts input inselection of tools for better prevention and management of NCD, position paperon Tomorrow‘s role of primary health care professionals and producing final reports of the project including model solutions for improvement of PHC practices = 11000 Euro