• Oversee the health administrative structure, education and leadership at the two model primary care clinics in Kharkiv and Chuguev.
• Support the professional development, role, and status of family practice physicians and nurses in the Kharkiv Oblast.
• Expand the use of primary care guidelines and develop a system to gather outcome data for ten clinical diagnoses, provide analysis of outcome data and use as a basis to implement quality improvement methods in the Chuguev Rayon and the Kharkiv Student Polyclinic.

• Develop a counseling program that will address the psychosomatic complaints and stress related symptoms of students at the Kharkiv Aerospace Primary Care Clinic and the Kharkiv Student Polyclinic.

• Develop and enhance urgent/emergency care services in the Chuguev Rayon and the Kharkiv Student Polyclinic to support the primary care clinics.

• Establish a comprehensive women's health program to serve adolescent through menopausal age groups in the Kharkiv Student Polyclinic and the Chuguev Rayon Hospital.

• The partners signed a Memorandum of Understanding on November 5.

• The partners conducted a student health risk assessment of over 700 university students in Kharkiv. The assessment results were analyzed and assisted the partners developing priorities for health education programs and awareness campaigns.

• In January 2001, two model primary care centers were opened – one on the campus of Kharkiv Aerospace University, and one in Korobochkino village, Chuguev rayon, Kharkiv.
• By July 2001 the partners established a patient education room in each of the two model primary care clinics, identified and trained an individual in each model primary care clinic to coordinate patient education.

• The Aerospace University clinic, along with physicians from Oblast Students Hospital and volunteers, conducted a health fair focused on the prevention of tuberculosis on March 24. Approximately 85 students from Aerospace University attended.
• On April 7 the Chuguev PHC sponsored a health fair which was well attended and covered in the local news.
• In May the Counseling Center affiliated with Kharkiv Oblast Students Hospital was opened.
• After graduating from the International Nursing Leadership Institute, a nurse from the Kharkiv Aerospace PHC established the Kharkiv Oblast Nursing Association in February 2002. The goal of the association is to lobby for the interests of nurses at the oblast level and at the MOH, provide information support, and enhance the roles and responsibilities of nurses in the Kharkiv Oblast.

• In April the partners trained psychologists and primary care physicians of Kharkiv oblast in counseling skills.
• On November 5-6, the partners conducted a workshop for representatives of all West NIS primary health care centers to share experiences and approaches on the development, implementation and assessment of effectiveness of clinical practice guidelines.
• The staff of the Students’ Counseling Center, Oblast Students’ Polyclinic and volunteers organized a health fair on April 7 in honor of World Health Day. During this event the students performed skits on healthy lifestyles, and condoms and leaflets on healthy lifestyles were distributed.

• January 27-28 nearly 60 health care professionals from Kharkiv Oblast and representatives from other AIHA partnerships from Ukraine and Moldova met in Kharkiv for a workshop on adolescent counseling.
• Representatives from the partnership shared their experiences in the development of the role of nurses in primary care setting during a nursing conference on January 29. Over 500 nurses from Kharkiv Oblast attended.

Primary Care

• The partners established a model primary care center (PHC) at the Kharkiv Aerospace University.  Serving a population of 7, 000 students, ages 16-28, the Kharkiv Aerospace PHC focuses on health education and promotion of healthy lifestyles among students.  As a result of a reorientation towards primary care, referrals to specialists decreased from 65% in 2001 to 32% in 2002.
• The partner established a model center that serves approximately 4,000 from the Korobochkino village, located in the Chuguev Rayon.  The rural clinic offers a wide range of primary care services including family planning, patient education, and counseling services.  Referrals to specialists in the clinic’s catchment area decreased from 60% to 25% in the first year the clinic was opened.
• The partners developed and implemented six clinical practice guidelines. The partners reported that the use of these guidelines reduced examination and treatment costs as well as the rate of unjustified hospitalizations.  In Korobochkino the rate of hospitalizations was reduced from 22.2 per thousand to only 5.5.
• Fifty PHC nurses, 120 polyclinic nurses and 30 hospital nurses received training in infection control through the partnership and preventative measures were put in place to against the occupational exposure to HIV.
• The partners developed a Healthy Lifestyles Curriculum for the first-year university students in Kharkiv and the classes began in September 2000.  The healthy lifestyle education course is now required for first year students attending Kharkiv Aerospace University. The curriculum is continuously reviewed and redesigned to stay current with healthy lifestyle topics that are important to students and is regularly evaluated by participating students.
• The partners and the Kharkiv Post Graduate Medical Academy developed a family medicine curriculum for physicians that include a combination of didactic lectures, practical skills training, and case discussion. The Academy and the partners also collaborated to develop a nursing curriculum that combines classroom lectures with clinical observation.  Twenty physicians and 18 nurses from the partnership graduated from a six-month postgraduate training course in Family Medicine/General Practice.
• In collaboration with the partners, the Kharkiv Post Graduate Medical Academy developed a four-year nursing degree program.
• Having received extensive training in primary care, nurses at the Kharkiv and Korobochkino primary care clinics are actively involved in direct patient care and act as the primary contact during a patient's visit to the clinic. These newly acquired responsibilities continue to redefine the role of nurses in the clinics and reduce the workload of the physicians.
• A partnership nurse who graduated from the International Nursing Leadership Institute established and registered the Kharkiv Nursing Association. The association initiated the revision of nurses’ job descriptions, expansion of their scope of practice and responsibilities and delegation of physicians’ functions during office visits to midwives, surgical, ophthalmologic and ENT nurses.
• The Kharkiv and Korobochkino PHCs are staffed with nurses who organize health education classes for individuals and groups and also conduct health promotion and health education community outreach campaigns.
• The primary health care centers in Kharkiv and Korobochkino served as replication models for the Kharkiv Oblast Health Administration.  By mid- 2004, over 200 family medicine clinics were opened in rural areas of the Kharkiv Oblast and six primary care clinics opened on campuses of several Kharkiv universities with funding provided by the Kharkiv Oblast Health Administration and Kharkiv Universities.
• Partners created a written instrument  to assess the satisfaction of patients visiting the primary care clinics and conduct patient satisfaction surveys on a regular basis.  The overall satisfaction with the services delivered at the clinics increased from 73.0% in 2001 to 95.7% in 2003.
• Korobchkino staff initiated community education in the areas of farm safety and hypertension prevention.

Mental Health

• The Student’s Counseling Center provides psychological support and counseling on a variety of behavioral health problems that pose a significant threat to students.  The programs offered by the Center include  substance abuse, smoking cessation, reproductive health, crisis intervention, and stress management.  The Counseling Center is equipped with a telephone hotline operated by trained volunteers.
• The Kharkiv partners, in coordination with representatives of Mental Health Task Force, presented the partnership’s model of mental health integration into primary health care and the manual for Family Doctors developed by Mental Health Task Force at the XIII Congress of the Russian Society of Psychiatrists in Moscow.

Emergency Medical Services

• Primary care physicians from Kharkiv and Chuguev received emergency medical training from the Donetsk EMS Training Center.  The physicians function as trainers for other medical personnel and community members, organizing courses on CPR and other first aid techniques

 
Women's Health

• The partners organized a system of breast cancer detection screening, self-examination, and community education for early detection of breast cancer and STI prevention, detection and treatment in the female population of Kharkiv Aerospace University and Chuguev rayon.
• Family planning centers were established as part of the PHCs in Kharkiv and Chuguev.  Over 8000 patients were served at the centers during the period of partnership activities.