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Armenia - Health Financing and Primary Health Care Development Project (Inglês)

The ratings for the project were as follows: the outcome was satisfactory, the sustainability was likely, the institutional development impact was substantial, and the Bank and borrower performance were both satisfactory,. The lessons learned indicate that introduction of provider contracting and changes in provider payment mechanisms need to be supported by substantial efforts to increase information flow, provider accountability, quality assurance and appropriate service delivery reforms to achieve the expected results. Unless public financing constitutes a significant share of provider income and the purchaser has the ability to enforce accountability, new provider payment systems are unlikely to have a significant impact on provider performance and efficiency. In a system with substantial excess capacity, payment reforms and provider autonomy alone will not result in significant efficiency improvements nor systems rationalization, if not supported by more decisive measures to concentrate resources on selected providers or active supply side interventions to reduce over capacity. Need to supplement class room and hospital based family medicine training with clinical training to allow family doctors to gain hands on experience in clinical setting. Need to improve the regulatory framework for family medicine in order to ensure that newly trained family doctors and family medicine nurses can practice their new skills and family medicine concept. The project demonstrated that any design weaknesses and/or emerging policy issues can be effectively addressed during implementation by using other Bank instruments, such as a structural adjustment lending program.


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    Conclusão da Implementação e Relatórios sobre Resultados

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  • Região

    Europa e Ásia Central,

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  • Nome do documento

    Armenia - Health Financing and Primary Health Care Development Project

  • Palavras-chave

    Primary health care management; Health care delivery; Training activities; Methodology; Financial information; Project management; Infrastructure; Budget management; Health care providers; Performance indicators; Project costs; Project financing; Economic costs; Benefits; Inputs; Ratings & rankings; Achievement outcomes; Outputs; Public finance; Clinical services; Regulatory framework; Lending instruments



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