Primary Care

• Improve the clinical and management skills of family physicians, nurses, and clinic managers and the use of modern medical equipment.
• Equip the four family medicine clinics with modern medical equipment.

Mental Health

• Improve the capacity of mental health professionals to provide quality services to the service area's population.

Curriculum Development

• Improve the education of medical students and introduce faculty development at L'viv Medical University.

Public Health

• Improve the health status of the region by developing assessment tools and encouraging community involvement.

• Partners signed a Memorandum of Understanding.
  
  

• L'viv Family Medicine Center (FMC), affiliated with L'viv Polyclinic #5, was opened on November 1.
• The FMC in Rudno was opened on November 1, as a satellite to the L'viv Center.
• Zibolky FMC, affiliated with Zhovkva Central Rayon Hospital, was opened on November 3.
  
  

• Dobrosyn FMC, affiliated with Zhovkva Central Rayon Hospital, was opened on August 30.
  
  

• The postgraduate training program for nurses developed by the Head Nurse of the Zhoyvka Rayon Hospital was approved and recognized by the L'viv Oblast Health Administration as a postgraduate training course for nurses.
• Red Flags, a training program to identify youth as risk for depression, was implemented to train teachers and others working with youth.
  
  

• Zhovka and Cleveland partners developed and published the Practical Manual of Mental Health, a guide for mid-level medical professionals to use in assessing and screening for mental health issues observed in family practice.
• The Ministry of Health of Ukraine approved the "Undergraduate Training of Family Doctors" developed by the partners.
• Two public health councils, in Dobrosyn and Zibolky, were established by the partnership.
  
  

• The Red Flags implementation program was presented by Zhovkva partners at the Global Health Conference in Washington, DC, in June 2004.

Primary Care

• Four FMCs were fully equipped comparable to modern US family medicine clinics. Physicians received training in the use of medical and computer equipment. Following training at subsequent exchanges to the FMCs the training and use of equipment was assessed and found to be well utilized and had improved the physicians' diagnostic capabilities and increased the scope of care provided to patients.
• The Head Nurse of the Zhovkva Central Rayon Hospital, a graduate of AIHA's International Nursing Leadership Institute (INLI), developed an Oblast-recognized postgraduate training program for nurses titled "Training of qualified nurses is an essential component of high-quality health care". She also developed standards of care for family nurse that have been successfully implemented at the Zibolki and Dobrosyn FMCs.
• The partners developed and implemented replicable training modules for physicians and nurses on diagnostics and management of diseases most common in the catchment area including asthma, diabetes, hypertension, otitis and coronary heart disease.
• An electronic patient chart was developed and introduced in the Dobrosyn, L'viv, Rudno and Zibolki, FMCs.
• Referrals to specialists in both L'viv and Zhovkva clinics decreased from 52% in 2001 to 24% in 2002.
• A patient satisfaction survey administered following the training of Zhovkva nurses (January- May 2002) demonstrated that 92% of the surveyed population positively assessed the work of the PHC nurses.
• From January 2002 through December 2003, eight training courses were conducted and 223 nurses from various health care facilities in the region were trained.

Mental Health

• Partners performed an assessment of mental health needs and developed a framework for a mental health training manual and a preventive education program aimed at youth.
• The L'viv FMC provides the consultation services of a mental health specialist who works with all age groups and with general family problems.
• The Red Flags Program, a community mental health program developed by the Ohio Department of Mental Health to raise awareness of depression in adolescents and to link the efforts of schools mental health professionals and parents was adapted and implemented in two schools of Zibolki and Dobrosyn as well as at summer camp "Ulybka". Seventy-two teachers received training as a part of the program. Eighteen classes were conducted for 270 students of Zibolki and Dobrosyn schools and 63 parents participated in the program. Zhovkva partners conducted seminars for representatives of the Childhood Council, Zhovkva Rayon State Administration as well as 13 school-based psychologists of the Rayon.
• The implementation of the Red Flags program has resulted in increased awareness among teachers, children and parents in the signs of childhood depression; 15% increase in number of visits to child psychiatrists; increased realization of the childhood depression problem by the community and removal of stigma attached to a "mental patient" diagnosis.
• The Zhovkva and Cleveland partners published the Practical Manual of Mental Health developed by the partnership. The manual is meant to be used by mid-level medical professionals, non-medical professionals, social workers, etc., for screening, detection and management of mental disorders most frequently observed in family practice.

Curriculum Development

• Partners developed and implemented replicable training modules for physicians and nurses on diseases common to the catchment area, including asthma, diabetes and hypertension.
• L'viv and Cleveland partners, in collaboration with the L'viv State Medical University, developed a family medicine training program for undergraduate medical students. The goal of the program is to enhance theoretical knowledge and the clinical skills of medical students in family medicine.
• Six hundred and fourteen undergraduate students from the LSMU medical departments were trained according to the Undergraduate Training of Family Doctors program developed by the partnership.
• A draft national standard for undergraduate training in Family Medicine was developed. In 2003 the Ministry of Health of Ukraine approved the undergraduate training program for family doctors developed by the partnership.
• An English version of the Partnership's Family Practice Manual was utilized in the training of 24 international students from L'viv State Medical University.
• The first Ukrainian textbook, "Polyclinic Care and Family Doctor" developed by the partnership was published in 2003.

Public Health

• Two public health councils with broad community representation were established in Dobrosyn and Zibolki. A "Public Health Leadership Development Guide" was also created to aid communities in creating public health councils that can be used as a voice for community health needs. The public health councils have regular meetings to discuss existing health issues as well as to develop health policy, funding support and intervention strategies.
• The Geographic Information System (GIS), software and training were provided to key staff that will enable data analysis and mapping as planning tools in developing the public health system.