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AstanaPittsburgh

Astana, Kazakhstan / Pittsburgh, Pennsylvania

1999-2004


Focus: Social Work, Primary Care



The Partners

US Partner: Pittsburgh Mercy Health System leads a consortium that includes: Sto-Rox Health Center, Allegheny County Health Department, Family Health Council Inc., University of Pittsburgh's School of Public Health, Women's Center and Shelter, Allegheny County Department of Human Services, and the Carlow School of Nursing.

NIS Partner: The Astana City Health Administration is the lead Astana partner. The City Health Administration identified former Children's Polyclinic #6 as the site for the new Family Medicine Center (FMC) that now has been developed through the partnership.


Partnership Objectives

The overall goal of the partnership is to improve primary health care in Astana by fostering the development of prevention-oriented, family-based primary care with integrated delivery of social services.

  • Obtain more information on the prevalent health problems and health service delivery in Astana and in the catchment area of the Family Medicine Center (FMC) to better target clinical services as well as community-based health promotion/education interventions.
  • Continuously increase the number of individuals from the catchment area who receive services from the model FMC and increase the number of high-risk individuals served by the FMC.
  • Improve training of primary care personnel at the FMC, focusing on such areas as patient education, health promotion and disease prevention; improve the quality and range of services offered at the FMC.
  • Develop the role of social worker as part of the primary health care delivery team at the Family Medicine Center; increase the number of individuals from the catchment area who receive integrated social and medical services; and expand the role of social worker within other family group practices.
  • Further develop a strong Community Advisory Board that becomes involved in solving the health care problems initially of the catchment area and then transfers this approach to other sites; and increase involvement of members of the catchment area in issues regarding their care.
  • Improve the diagnosis and treatment of sexually transmitted infections in Astana by establishing a model program for the catchment area of the FMC, in collaboration with the STD Hospital; and increase collaboration between the FMC and the Narcology Hospital to strengthen coordination of services for drug/alcohol abusers within the catchment area and to increase the availability of addiction services for this group.
  • Increase understanding among other family group practices in Astana about how to improve primary health services consistent with the model developed at the FMC; provide training and support for a second model program.



Achievements

  Primary Care

  • The Family Medicine Center was opened in November 2000 to serve a catchment area population of around 16,000. The center’s physicians and nurses were trained in Pittsburgh, Almaty, and Zhezkazgan. The center hired and trained a clinic manager, developed contracts with suppliers, conducted media campaigns, developed reporting forms, and collected information about catchment area families.
  • A gala opening and public introduction of the FMC was held in February 2002. The ceremony was attended by US partners, international guests and local government officials.
  • FMC staff collects data on the numbers of patients and visits, the reasons for home and clinical visits, the most prevalent diseases, and activities of the clubs organized by the center. Since the center’s opening, the number of catchment area residents served has consistently increased from one reporting period to the next.
  • Nursing staff from the FMC and other family group practices initiated classes on family medicine at the Astana Medical College. Topics covered in the classes include: the meaning of family medicine, integration of social programs and primary healthcare, disease prevention, medical equipment use, and management of health services.
  • Carelift International provided training sessions for FMC staff on the use of selected medical equipment. The same training was provided at the FMC for nurses from other family group practices and polyclinics.

  Community Board/Community Outreach

  • A large multi-disciplinary Community Advisory Board (CAB) was established, and it actively supports the FMC’s preventive programs for high-risk groups. The Board identified the following risk groups in the catchment area for targeted interventions: orphans, low-income families, tuberculosis patients, alcoholics, drug addicts, diabetics, and mental health patients. Activities have included distribution of a newsletter on family medicine for parents and children, education of adolescents related to sexual and reproductive health as well as alcoholism prevention, meetings with senior citizens, creation of a group to promote breastfeeding, and seminars for women on gender issues (such as domestic violence and protection of women's rights).
  • Other CAB activities have included: attracting media and the public to a health promotion fair at the FMC, initiating a new “hot-line” for FMC patients to provide information on the most common diseases, promoting consultation services for drug and alcohol addicts, conducting a family planning survey among women in the catchment area, promoting social services to the elderly and students, arranging TV programs to address questions related to family medicine, and evaluating CAB and FMC activities.
  • The partnership was the impetus for exploration by Astana and Pittsburgh city officials of the feasibility of initiating a Sister City relationship.

  Patient Clubs

  • Astana partners organized numerous patient clubs and an NGO for the elderly; these clubs have been very active.
  • Patient clubs, in cooperation with the police, sponsored meetings with high-risk teenagers, juvenile criminals and prostitutes.
  • Two clubs--“Healthy Parents/Healthy Descendants” and “Trust”--held trainings in STD/HIV and pregnancy prevention for high school students. The clubs also held meetings on family planning and STD prevention.
  • The “Honorable Age” club conducted health promotion sessions and cultural activities for the elderly.
  • Cardiology Club members were trained in self-help and mutual assistance in dealing with high blood pressure.
  • Parents of disabled children, representatives of an Astana NGO for disabled children, government officials and members of the “Safe Childhood” club met to discuss challenges and needs of families with disabled children. These meetings will continue each month.

  Social Work

  • A British volunteer social worker provided trainings on social work and community needs to FMC staff. She also visited other family group practices, social protection and law enforcement agencies to promote cooperation and the integration of medical and social care.
  • Two social workers of the FMC received training on how to serve vulnerable groups in the target area.

  STDs/Drug Abuse

  • Partners have worked in the areas of epidemiological control, STDs and HIV/AIDS prevention, and drug abuse.
  • The FMC (with assistance from the Astana HIV/AIDS Center) set up a “We Trust Each Other” station for exchange of syringes and distribution of condoms and educational information to high-risk populations. Volunteers developed a confidential survey to obtain information on the drug user's age, length of time addicted, and other important data.


Participating Institutions



Contact Information for Astana, Kazakhstan / Pittsburgh, Pennsylvania

NIS/CEE Partners

Information Coordinator
Eshchanova, Ainur
Family Medicine Center "Demeu"
Astana, Kazakhstan
demeu00@kepter.kz

NIS Partnership Representative
Shaidarov, Mazhid
Director
City of Astana - City Health Administration
Astana, Kazakhstan

Information Coordinator
Isayeva, Nazym
Family Medicine Center "Demeu"
Astana, Kazakhstan
demeu00@kepter.kz

NIS Partnership Representative
Abzalova, Roza   MD
Chief Physician
Family Medicine Center "Demeu"
Astana, Kazakhstan
demeu00@kepter.kz

 

US Partner

US Partnership Coordinator
Carrasco, Mary   MD, MPH
Director of International and Community Health
Pittsburgh Mercy Health System - Mercy Children's Medical Center
Pittsburgh, PA, United States
mcarrasco@pol.net



Related Events

  Memorandum of Understanding Signing: American International Health Alliance and the Ministry of Health and the Ministry of Labor and Social Welfare Astana, Kazakhstan
December 9, 2004
AIHA hosted a ceremony to mark the signing of a Memorandum of Understanding (MOU) among the Kazakh Ministry of Health, Ministry of Labor and Social Welfare, and AIHA. The document will solidify the collaborative relationship among the three parties and their commitment to strengthening family medicine and social service programs by introducing the community-oriented primary care model throughout various regions of Kazakhstan.



Updated on May 28, 2003