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AshgabatNorthDakota

Ashgabat, Turkmenistan / North Dakota

1999-2003


Focus: Medical Education, Emergency Medical Services, Primary Care



The Partners

US Partner: The University of North Dakota and the North Dakota State Health Department lead the North Dakota Primary Health Care Consortium, which also includes: Family Health Care Center, St. Aloisius Medical Center, West River Regional Medical Center, and Dakota Association of Community Health Centers.

NIS Partner: The Ministry of Health and Medical Industry (MOHMI) has as one of its goals the retraining of specialized physicians into family physicians to expand primary care in Turkmenistan. Polyclinic #1 in Ashgabat was selected as the site for the Primary Care Training Center (PCTC) has now been established through the partnership.


Partnership Objectives

The partnership's overall goal was to strengthen the primary health care system in Turkmenistan by developing a skills-based primary care curriculum and retraining program for physicians, nurses, and feldshers.

  • Strengthen and expand the capacity of the Primary Care Training Center to deliver a skills-based primary healthcare retraining program
  • Increase availability of continuing education opportunities in areas related to primary healthcare for physicians, feldshers and nurses in Turkmenistan.
  • Improve the quality of primary healthcare delivery in a model unit(s) within Health House #1.
  • Improve access of primary healthcare professionals to up-to-date medical information and resources to support training received at the PCTC.
  • Increase the role of the PCTC in national primary healthcare reform efforts and in coordinating with the Ministry of Health, the Medical Institute and other donor-funded programs.


Key Events

  2000

  • In late January, three of the future trainers (two physicians and one nurse) began an intensive five-week training program in primary health care in North Dakota. During the training, the NIS partners rotated through multiple sites throughout urban and rural areas of North Dakota, observing a wide variety of clinical settings, ranging from urban facilities in Grand Forks and Bismarck to rural health care delivery systems in Hettinger and Harvey.

  2001

  • The Family Medicine Training Center (FMTC) at Health House #1 officially opened in Ashgabat on May 14. Seventy people, including the US Ambassador to Turkmenistan, USAID and AIHA representatives, US partners from North Dakota, government officials and local healthcare practitioners gathered for the ceremony. US Senator Byron Dorgan of North Dakota sent partners a congratulatory note that was read aloud at the ceremony.
  • The FMTC held its first training course beginning on May 14. The unique one-month curriculum was jointly developed by North Dakota and Turkmen partners and focuses on skills training in assessment, diagnosis, treatment and monitoring as well as on health promotion and illness prevention in clinical and home settings. The training program, which emphasizes a team approach within the practice setting, will be taught by qualified Turkmen physician-nurse instructor teams who have received basic and advanced training provided by the North Dakota partners in North Dakota and Ashgabat.
  • In July the Turkmen partners conducted a workshop on primary care services for directors of the health houses in the of city of Ashgabat.

  2002

  • In August the partnership information coordinator conducted an open house event for medical workers and administrators.

  2003

  • North Dakota partners assisted their partners in Ashgabat with the development of a new module on women's health that was been added to the curricula of the Family Medicine Training Center (FMTC).
  • In September, two Turkmen Ministry of Health administrators traveled to North Dakota, visiting hospitals, family practice sites, and the University of North Dakota School of Medicine. The visitors learned about healthcare financing and insurance systems, reviewed nursing curriculum, and discussed the University's medical education system with residents and students.



Achievements

  Curriculum and Faculty Development

  • Partners developed a month-long skills-based primary healthcare retraining curriculum covering a wide range of topics, as well as a pre- and post-training evaluation tool for trainees. In addition, partners prepared protocols for evaluating trainers and established evaluation criteria for each teaching module. Protocols were also developed for evaluating the work of the Center.
  • The PCTC officially opened in May 2001 with six physician and nurse trainers who were trained in North Dakota and Ashgabat. The PCTC conducted approximately one 4-week training program each month for 8 physician-nurse teams (or 16 individuals, on average) each session. By the end of the partnership the center had trained over 600 medical workers.
  • All PCTC staff were trained in computer literacy and Internet use.
  • The partners, with AIHA support, drafted a ministerial order on the status of the PCTC. The order was designed to incorporate the Center into the existing medical education system, to assign full-time staff, and to certify the courses. The Turmenistan Ministry of Health and Ashgagat Health Department required that all physicians and nurses in Ashgabat receive training at the center.

  Primary Healthcare Services

  • Partners developed a model primary healthcare unit at Health House #1. The unit consisted of 10 physicians and 10 nurses who received training at the PCTC. At unit worked on an appointment basis, with physician/nurse teams. The nurses took patient histories, documented patient charts, and the physicians assessed and treated patients according to established clinical practice standards.
  • The model healthcare unit conducted community outreach such as health education programs in schools, supporting patient support groups and clubs, and health fairs.
  • Several changes were noticed in diagnostic trends as a result of the increased knowledge among health workers who participated in the training at the PCTC. For example, early diagnosis of breast cancer improved because of the increased practice of clinical and self-breast exams. The need to refer patients to specialists has also decreased due to the ability of the providers to properly use otoscopes and opthalmoscopes.
  • Providers who received training at the PCTC improved communication skills and learned patient-focused, rather than disease-focused care. The partners reported that this reorientation increased efficiency and increased trust among medical workers.

  Other

  • A grassroots network of organizations representing over 100 communities throughout North Dakota assembled thousands of new layette sets for the families of newborns in Turkmenistan. The donation, valued at over $100,000, was distributed through Health House #1.


Participating Institutions



Contact Information for Ashgabat, Turkmenistan / North Dakota

NIS/CEE Partners

NIS Partnership Representative
Nazarova, Akchagul  MD
Deputy Minister of Health
Ashgabat, Turkmenistan

Information Coordinator
Ardzhanova, Maral
Hospital #1 - Family Medical Training Center
Ashgabat, Turkmenistan
Email:  dmzd1@online.tm

NIS Partnership Representative
Nedirova, Mekhri  MD
Director
Hospital #1 - Family Medical Training Center
Ashgabat, Turkmenistan
Email:  dz1@online.tm



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Updated on July 17, 2007