제    목 : Preventive health care policies of Russian Federation
 국    가 : Russian


    The European Union's Relations with the New Independent States and Mongolia

    Contract Information

    Budget 1996

    Russian Federation

    Preventive health care policies

    Human resources development

    Project cost

    ECU 4 million

    Partner organisation(s)

    Ministry of Health.

    Rationale and objectives

     Mortality and morbidity in Russia have drastically increased due
     to a number of reasons, primarily bad hygiene conditions,
     pollution, unsatisfactory occupational safety, insufficient
     awareness of the population, and emergence of a double track
     health care system. This development is taking place in spite of
     the availability of a wider range of health products and
     activities, and the increase of NGO activity in the health
     sector.

     Previous Tacis assistance in the field of health care reform has
     focussed on the primary health care system and the issue of
     hospital management in the cities of St. Petersburg, Samara,
     Ekaterinburg and Kemerovo. The World Bank is currently preparing
     a loan (US$ 70 million) to support the reform of the Russian
     health care system. In particular, the loan will serve to
     restructure health services in two pilot oblasts, Kaluga and
     Tver, so as to i) increase the efficiency and effectiveness of
     the oblasts' health services, within the limits of the oblasts'
     financing capacities; ii) initiate a national programme to
     introduce the practice of family medicine as the basic model for
     primary health care delivery in the country.

     Structural reforms of the health care system can only be
     successful in improving cost efficiency if they are accompanied
     by a shift from a culture of provision to a culture of
     prevention. With this purpose, the present project will support
     the Ministry of Health in developing and implementing a policy
     emphasising the need for information on health matters,
     awareness, and proactive behaviour.

     The 1996-1999 Indicative Programme singles out support to the
     health sector as a priority for Tacis action. Against this
     general background, the specific objectives of this project are
     as follows:

        * to elaborate a long term action programme for reducing the
          main epidemiological problems, involving people at risk as
          well as social workers, medical staff, teachers and public
          administration officials
        * to support the creation of networks in the social and health
          care professions at central and regional level with the
          support of (local) administrations, NGO's, etc.
        * to improve the health management systems in selected
          regions, focussing in particular on issues of detection,
          monitoring, information, education, and communication.

     Main components

     The main components of the project are the following:

        * to carry out system analyses of selected epidemiological
          problems in selected regions. Afflictions to be given
          priority would be
             o those implying vaccination or early drug intervention
               such as diphtheria and tuberculosis
             o those related to occupational safety such as silicosis
             o those primarily related to standards of living such as
               diabetes (a related decree outlining an action
               programme has been passed in June 1996), hypertension,
               or infant mortality
        * to assist in the development of action programmes on
          specific epidemiological issues such as children's health
          education, vaccinations, and appropriate training of medical
          staff
        * to assist in the implementation, management, and monitoring
          of such action programmes
        * to provide specific training required for the implementation
          of such action programmes both at federal and selected
          regional level
        * to provide communication expertise in order to increase the
          population's awareness of the basic principles and means of
          preventive health care
        * to enhance the information system required for improving
          different epidemiologies.

     The Ministry of Health is the federal body responsible for health
     care policies and programmes. The Ministry is the recipient of
     the ongoing Tacis project on primary health care (1993 Action
     Programme), and has expressed its interest in Tacis assistance to
     develop and implement preventive health care policies and
     programmes.

     implementation timetable

     36 months

      Budget

     Budget                            ECU
     --------------------------------------
     Expertise                   3,400,000
     Study tour                    200,000
     Equipment                     400,000
     --------------------------------------
     Total                       4,000,000

     Russian Federation