USAID - Health

OBJECTIVE

Health Sector Assistance

Increased Use of Quality Health Care Services and Practices

Azeri doctor from the USAID-supported Ganja Primary Health Care Training and Demonstration Center measures a patient's blood pressure.

An Azeri doctor from the USAID-supported Ganja Primary Health Care Training and Demonstration Center measures a patient's blood pressure.
USAID health sector activities focus on health system strengthening, including increasing financing and improving resource allocation for health, improving primary health care services, increasing access to quality reproductive health and family planning services, improving emergency medical services, and strengthening personal responsibility for individual and family health. Since 2002, USAID has provided over $13.036 million for health projects in Azerbaijan and in 2006 will provide nearly $3.8 million. All health sector activities support the strategic goals of the country�s State Program on Poverty Reduction and Economic Development to achieve the targets set out by the United Nation�s Millennium Development Goals.

CURRENT SITUATION

Azerbaijan has some of the poorest health outcomes in the region. The infant mortality rate is estimated at 79 per 1000 live births and under 5 child mortality is estimated at 92 per 1000. Life expectancy is about 64 years and has been in decline. The main causes of child mortality are respiratory diseases and dehydration due to diarrhea. Circulatory diseases, related to unhealthy lifestyle choices, such as poor diet, tobacco, alcohol and lack of exercise, are the main causes of premature adult mortality. Furthermore, male mortality related to injuries is three times higher in men than women. Although fertility is low, only 7% of Azerbaijani women use modern family planning methods, while women on average have 3.2 abortions. Public expenditures for health account for approximately 20% of the total health expenditures, with the government spending less than 1% of the GDP on health.
The Government of Azerbaijan is pursuing needed health reforms. To address the poor health outcomes, the Ministry of Health of the Republic of Azerbaijan is seeking to improve health care financing and to improve the quality of health care services.

PROGRAM FOCUS

USAID/Azerbaijan supports the Government of Azerbaijan in its health reforms through policy dialogue and piloting in targeted sites. Projects seek to enact and operationalize policies and a legal framework that are supportive of health care reforms; improve the mobilization, allocation and use of health care resources; improve the quality of health care services; and to assure that people are better informed about and can advocate for health care services, healthy life styles, and patient rights and responsibilities leading to achievement of the strategic objective to increase use of quality health care services and practices in Azerbaijan.

Children peer into the local health clinic, where they now receive vaccines regularly.

Children peer into the local health clinic, where they now receive vaccines regularly.
To achieve these results, projects are working to improve and strengthen:

� health care financing and resource allocations;
� primary health care services, including maternal and child health and non-communicable diseases;
� family planning and reproductive health care services;
� emergency medical services; and
� behavior change and communications.

SUCCESSES

� With technical assistance from USAID�s Primary Health Care Strengthening Project the Ministry of Health has designed the Health Sector Reform Project (funded by a World Bank loan and the Government of Azerbaijan).

� The Ministry of Health recently expanded its Emergency Medicine network to 12 hospitals throughout the country, four of which are USAID�S Emergency Medicine Development Initiative�s (EMDI) pilot sites. This expansion is based on the designs and technical input from EMDI.

� Based on the foundation built by USAID�s Primary Health Care Strengthening Project the Azerbaijan Cabinet of Ministers issued a decree establishing a Coordination Council �to improve the health care quality, to conduct structural reforms in the field and to implement a compulsory medical insurance system through adapting the Azerbaijan Republic primary medical aid mechanisms to the modern demands.�

� Materials for Integrated Management Childhood Illnesses (IMCI) were adapted for Azerbaijan and health care providers in nine districts across the country attended IMCI trainings.

� Ministry of Health has adopted IMCI as a national protocol and currently receives technical assistance from USAID health projects to plan national rollout.

� More than 33,000 community members received training from peer educators on a variety of health topics.

� Training on Family Planning and Reproductive Health was provided by peer educators to over 35,000 women and men.

� Through a U.S. � Azerbaijan health partnership a Community Advisory Board works to enhance community participation in the health care system and to link the public to primary health care services in Ganja.

� The Working Group on Primary Health Care Strengthening has been formed. Its mission is to develop an overall concept of primary health care reform for Azerbaijan and to recommend strategies to achieve these health reforms.

� USAID health projects provide support in the development and expansion of the Family Medicine/General Practitioner curriculum for the Institute of Advanced Medical Studies (the institute responsible for continuing medical education).

� The Technical Working Group on Emergency Medicine has been formed. Its mission is to develop an overall concept of emergency medicine reform for Azerbaijan and to recommend strategies to achieve these health reforms.

� Yevlakh Central District Hospital has been renovated and re-structured to create an emergency department combining the roles and functions of three formerly separated departments; admissions, trauma, emergency and resuscitation treatment. Similar renovations are planned for hospitals in Ganja, Shamkir and Kurdamir.

PROGRAM ACTIVITIES

Primary Health Care Strengthening

This project provides technical assistance to the Ministry of Health on primary health care (PHC) reforms. It focuses on increasing health care financing and improving resource allocation for primary health care, redefining and restructuring PHC community-based services, improving the quality of PHC services and promoting personal responsibility for individual and family health. The Ministry of Health is initiating PHC reforms with support of the World Bank and will pilot these reforms in Gakh, Sheki, Agdash, Ismailli and Absheron regions. USAID's PHC Strengthening Project is a partner in these efforts working in these regions. Additionally, this project supports the Ministry of Health on human avian influenza disease surveillance and health promotion/communications.

Family planning brings happiness and peace to Azeri families throughout Azerbaijan through USAID's Reproductive Health and Family Planning Project.
ACQUIRE Reproductive Health/Family Planning Project

The project addresses the reproductive health and family planning needs of Azerbaijanis by increasing the use of affordable, modern contraceptive methods and ensuring a broad method mix. This project works closely with the Ministry of Health and local District Health Departments, as well as NGOs, communities and the private sector. ACQUIRE focuses its work in Ismayilli, Shamakhi, Aghsu, Kurdamir and Goychay with additional work in Imishli, Beylagan, Agjabedi, Barda, Ter-Ter, Yevlakh, Goranboy and Mingachevir regions.

Azerbaijan Demographic and Health Survey

USAID is conducting a demographic and health survey, in collaboration with UNICEF, to generate a wide range of reliable health data for planning and decision-making. This national survey is being conducted by the State Statistics Committee of the Republic of Azerbaijan under the Cabinet of Ministers.

Azeri children from a drama club celebrate Child Protection Day in Shuvelan, urban region of Azerbaijan.
Community-Based Support Services for Marginalized Children Program

This project aims to promote social integration and strengthen community to care for approximately 11,300 marginalized children, including institutionalized children, internally displaced children, children affected by poverty, children of single-headed households, children with disabilities and street children. Activities are implemented in Goranboy, Mingechevir and Shuvelan districts of Azerbaijan.

Emergency Medicine Development Initiative

This project works to strengthen the Ministry of Health�s emergency response capacity through policy dialogue, training emergency medical staff and first responders, improved information systems and by upgrading equipment and facilities. Emergency medicine departments and training centers are being upgraded in Shamkir, Ganja, Yevlakh and Baku. Equal funding for this project is provided from the private sector comprised of a consortium of oil companies.

Child Survival

Working in mountainous districts near the Iranian border (Masally, Lerik and Yardimli), this project aims to decrease the mortality and morbidity of children under age 5 by strengthening the skills of health care providers and improving care seeking behavior among community members.

ASSESSMENTS AND OTHER PUBLICATIONS

CD Assessment-Dec 2004       [1.55MB]

PHC Assessment Final 2-01-05      [2.08 MB]

Social-Health Assmnt of Residents, Refugees &IDPs     [3.98 KB]

LIST OF ACTIVITIES