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BakuPortland

Baku, Azerbaijan / Portland, Oregon

2000-2004


Focus:  Disease Prevention, Information Technology, Epidemiology, Community Health, Medical Education, Primary Care, Public Health, Curriculum Development, Nursing Education and Practice



The Partners

US Partner: Oregon Health Sciences University in Portland, Oregon is the only educational institution in the state exclusively devoted to healthcare, health education, and related biomedical research. As the major health training facility it educates students and residents, provides patient care and public service, and conducts biomedical research. As a leading healthcare university, it has all medical disciplines located within one institution, vast connections with community resources, and a wide breadth of resources, skills and expertise.

NIS Partner: The Narimanov District Health Administration, in Baku, Azerbaijan serves the Narimanov District, which is a downtown, densely populated area with a population of 177,000, including 26,000 IDP/refugees. Primary care is provided through the adult and pediatric polyclinics reporting to the District Health Administration. The Health Administration is also responsible for the work of the Women's Health Clinic as well as the Children's Infectious Diseases Hospital.


Partnership Objectives

The overall goal of the partnership is to develop a comprehensive, community-based, primary care system designed to meet basic health care needs and improve the status of IDPs and refugees in the Narimanov Health Care District in Baku. Specific partnership objectives are to:

  • Enhance the ability of the Narimanov Health District to collect, store, organize and analyze basic socio-demographic, health status, and clinical information on the IDP and refugee population in the district.
  • Adapt the infrastructure of the Health District to the extent strictly necessary to allow the Health District to provide primary care within the IDP and refugee population. Specifically the partnership will develop a model primary care clinic that can function as a "base of operations" for the work with IDPs and refugees within the District.
  • Improve the effectiveness of the "Visiting Physician" program as it pertains to the IDP and refugee population by increasing the capacity of the visiting physicians in areas related to delivery of community-based primary care, use of community assessment and epidemiological surveillance tools, and public health, including patient education and the use of self-care materials.
  • Improve the effectiveness of the nurses in the Narimanov District to serve the IDP and refugee population.
  • Develop the capacity of the IDP and refugee population to participate in improving individual, family and community health status. This capacity building will include use of health education materials focused on infectious and communicable diseases, sanitation, mental health, and nutrition.



Key Events

  2000

  • On May 30, the partners signed a Memorandum of Understanding.
  • Partners worked with the NGO "New Century" and the "Ibn Sina" clinic to screen IDP and refugee children residing in the Narimanov District. A mobile team of pediatricians, cardiologists, and dentists screened 176 children for a variety of pediatric conditions and identified 160 positive pathologies. Forty-six patients were referred to Narimanov District clinics to obtain necessary medical care.

  2001

  • The US partners provided medical and nursing bags similar to those used by the American Visiting Nurses Association (VNA). A family medicine team conducted training for doctors and nurses in the use of the new equipment and supplies and the bags were piloted in January in Baku.
  • The partners opened a new breast health education center in Polyclinic #4 to train physicians in current techniques of breast examination and treatment. They will also learn how to teach patients to do self-breast exams. This center was later connected with the Narimanov District model PHC clinic.

  2002

  • In February, a Memorandum of Understanding was signed between the representatives of the Narimanov Health District and UMCOR. The agreement stipulated that UMCOR would regularly supply medicines and medical supplies to those physicians who provide PHC services to IDPs and refugees.
  • Beginning in May, local nurses started weekly meetings at the Narimanov Health Administration to discuss primary care nursing services for IDPs and refugees, appropriate data collection, and health/patient education.
  • The Minister of Health of Azerbaijan appointed the Azeri partnership coordinator as the National Coordinator of Family Medicine.

  2003

  • In April, in coordination with Save the Children, two Narimanov partners implemented a three-day training on self breast examination in Barda, field district, where there is a high density of refugees and IDPs.
  • With the support and technical assistance of the Narimanov and Portland partners, a training course on Family Medicine was established at the Azerbaijan Institute of Postgraduate Medical Education.
  • The Azerbaijan Institute of Postgraduate Medical Education signed an agreement with the Narimanov Health Administration to utilize Polyclinic #4 in the Narimanov District as a main clinical base for their training course on family medicine.
  • The Portland partners provided assistance to their local counterparts in developing the Cardiovascular Diseases' Prevention, Diagnostics and Treatment Manual at the request of UNICEF. The manual was utilized in five pilot districts where the Ministry of Health and World Bank implement healthcare reforms.

  2004

  • The partners officially opened a new model Primary Care Clinic on May 21. The clinic included a community health education and resource center and provided a base of operation for existing programs focusing on women's health, addictions among youth, asthma, and mental health.
  • Ten physicians graduated from the training course on family medicine at the Azerbaijan Institute of Postgraduate Medicine. Upon completion of the training, these physicians were certified as family physicians and became faculty members at the chair of Family Medicine. The clinical base for family medicine stems from the model primary care clinic in Narimanov District, Baku set up by the Baku/Portland partnership.
  • Narimanov physicians implemented training sessions on Prevention and Treatment of Cardiovascular Diseases in settings in three rural areas of Azerbaijan. The training was organized by UNICEF as a component of the current health reforms implemented by the MOH.
  • The Portland partners provided assistance to their Narimanov counterparts in developing the Family Medicine Program at the request of UNICEF. The program is being utilized in five pilot districts where the Ministry of Health and the World Bank are implementing healthcare reforms.


Achievements

  Clinical Organization and Capacity Building

  • The partners developed a training curriculum to increase the diagnostic and treatment skills of the visiting physicians with a focus on issues common among the IDP and refugee population. This curriculum includes basic exam skills, basic survey of systems and other core competencies needed by primary care providers. A weekly training program was initiated for general physicians using the curriculum. They received training on the use of equipment in medical bags and advanced training for opthalmologists, neuropathologists, and other specialists regarding issues deemed crucial to the IDP/refugee population.
  • The partners developed a similar curriculum for visiting nurses working with IDPs and refugees, with an emphasis on basic skills necessary for continuity of care and comprehensive care of both sexes and all ages. The training included physician trainees in the early stages of the nursing curriculum to help them understand the expanded role of the nurses.
  • Twenty physicians and 20 nurses were trained in the newly developed curricula. As a result of this reorientation toward family medical care, the partners were able to reduce the number of visits to the polyclinic and the number of required house calls. In 2002, over 6,200 patients were screened, and 2,003 cases of disease were detected; 40% of those received consultations at the clinic, and fewer than 12% of those needed to be referred to specialists.
  • The partners worked to improve clinic infrastructure, and performed functional analyses of patient flow and medical record-keeping. Computers were donated and installed to contribute to data collection, storage, analysis and retrieval. US partners conducted training sessions on clinic infrastructure and functional analysis, patient flow, data tracking and medical record-keeping.
  • The Azeri partners from the Portland-Baku partnership continue implementation of a clinical practice guideline on bronchial asthma. Sixty one patients were involved in the project since the beginning and 11 patients joined in January 2003. In February 2003, 32 of the 72 patients (44.44%) achieved the desired outcome of a Peak Expiration Volume (PEV) greater than 80%. The patient outcomes continued to improve through a six-month period -- the number of patients who had their asthma under control increased by 18.72%. From April through June 2003, 59.21% of patients achieved the desired PEV and July through September 2003 63.16% achieved the desired PEV.

  Community/IDP Outreach

  • The partners developed model medical and nurses' bags with basic equipment and supplies for visiting physicians and nurses to enhance their ability to do examinations and provide basic treatment while visiting IDP and refugee sites.
  • The partners developed a collaborative relationship with UMCOR to ensure the regular supply of medicines and medical supplies to those physicians from the clinic who provide primary care services to IDPs and refugees.
  • The partners collaborated with the Azeri NGO "New Century" and the Ibn Sina Clinic to conduct screenings for the IDP and refugee children residing in the Narimanov District.
  • The partners established a model Primary Care Clinic. The clinic included a community health education and resource center and provided a base of operation for existing programs focusing on women's health, addictions among youth, asthma, and mental health. As a result of the work done at the clinic, the partners report that the rate of timely disease detection has increased by 19 percent.
  • The partners established an educational Breast Health Center that offered a breast health program, including teaching the basics of self-examination and dissemination of educational/information materials on breast health to IDPs and refugees residing in Narimanov District. By the end of 2002, over 600 medical workers had been trained on breast screening, and over 12,000 patients (2.5% of the population) had received screenings and information. Among the patients screened, 470 abnormalities were found and 2 cases of breast cancer were detected.


Participating Institutions




Related Events

  PHC Opening in Baku (Baku/Portland Partnership) Baku, Azerbaijan
May 21, 2004
 A model primary care center was officially opened in the Narimanov District of Baku on May 21. The clinic included a community health education and resource center and provided a base of operation for existing programs focusing on women’s health, addictions among youth, asthma, and mental health.



Updated on November 19, 2004