Anush Poghosyan, co-founder of "Health Rights and Human Rights Defenders" NGOwrites:
The future has reached the medical clinics of Geharkunik. Family medicine was introduced into the RA healthcare system in 1997. the service of the primary care polyclinic was replaced by the Institute of Family Medicine.
The goal is to control the course of diseases, the introduction of a healthy lifestyle, continuous medical supervision of all family members, primary health care.
The decision was based on preliminary expert studies and economic calculations, which were carried out by the RA Ministry of Health with the participation of international experts, with the support of the World Bank Health Program Implementation Office (IPO).
The development of the primary health care sector, as the field that implements the key function of the health care system of each state, as the first contact link between the person, the family, the community and the health sector, the best example of which is the Institute of Family Doctor, continued to be one of the priorities of the strategy of the Government of the Republic of Armenia in the coming years.
https://www.e-draft.am/projects/7969 is circulating a draft of the draft decision of the Government of the Republic of Armenia "On additions and amendments to the Decree of the Government of the Republic of Armenia of November 2, 2006 N 1911-Н", the necessity of which is due to with the need to implement changes in the healthcare systems of Gegharkunik region of RA.
According to the project, 30 medical ambulatory "bunches" are being optimized.
A few questions for project developers:
1. Quotation from the justification of the project: "As a result of the merger, reduction of the administrative staff is expected, which will lead to an increase in the salary of the administrative staff of the "bunch", as well as economical, combined and saved financial resources will be generated, which will be directed to the purchase of equipment necessary for the effective operation of the organization."
Question: What is meant by saved, combined and saved financial resources, what calculations and methodology were used in the basis of the calculations, was the cost-effectiveness calculated, how many people will be reduced so that the salary of the new administrative staff will increase, how will the new administrative staff be selected?
Answer: they don't know.
2. Excerpt from the rationale of the project: As a result of the proposed restructuring, the volume of purchasing processes necessary for the organization's activities will increase, especially for the acquisition of the required medication, which will lead to increased interest of participants, increased competition and reduced prices.
Question:
In other words, are you liquidating the infrastructures of rural communities because you are unable to organize a purchase process? Answer: yes.
3. Excerpt from the justification of the project: "As a result of the mentioned optimization, management in the primary health care sector in the region will be brought to a qualitatively new level, the proposed reorganization will contribute to the implementation of medical care and service exclusively by medical specialists and the implementation of more quality, accessible and affordable medical care and service, health indicators, improving the satisfaction of the population".
Question:
How many health indicators have you analyzed and how many are you going to improve with this project, by what indicators will you evaluate the most qualitative, accessible and affordable medical care and service?
Answer: they don't know.
4. Excerpt from the project justification: As a result of the retrofitting, certain services will be more accessible to the population, these services will be provided locally.
Question:
Do you have a development plan, cost-effectiveness calculation of new services?
Answer: no.
And most importantly, this project was never discussed with the directors of those 30 outpatient clinics, many of whom have work experience as old as the draft writers.
PS: We have reached the last level of the disintegration of the health care system, the elimination of rural dispensaries...
