• Develop a model family medicine clinic in the central polyclinic of Velykobereznyi Rayon that ensured local access to health care, continuity of care, quality of care, and cost effective services.
• Increase access to and utilization of health care services in the Velykiy Berezny and Uzhgorod catchment areas.
• Develop communications, information management systems and computer technology for the Velykiy Berezny Family Medicine Clinic (FMC) and the Uzhgorod WWC.

• Establish a Women's Wellness Center (WWC) in the Central Oblast Hospital in Uzhgorod for the improvement of family planning, reproductive, diagnostic and preventive health care for women.

• Increase understanding of personal heath responsibility through coordinated and comprehensive community and school health campaigns focused on healthy lifestyles and healthy communities.
• Increase the level of community trust in the physicians, nurses and clinic services and health care system at the Velykiy Berezny FMC and at the Uzhgorod WWC.

• Develop a well-equipped dental facility at the central polyclinic in Velykiy Berezny and at the Uzhgorod University Family Medicine Training Clinic as well as a youth dental education intervention and fluoride program in Velykiy Berezny.

• Establish a mutually beneficial linkage between the training programs for family practice physicians at Oregon Health Sciences University and the medical faculty at the Department of Post Graduate Training at Uzhgorod State University.
• Develop a family practice training curriculum and establish a model family practice clinic with qualified trainers for the training of family physicians will the general university population and individuals in Uzhgorod.
• Develop and implement a comprehensive plan to address ongoing training needs of the clinic staff.
• Establish a skills lab at the Uzhgorod University Family Medicine Training Clinic for family medicine residents and for physicians and nurses in family medicine clinics to participate in practical clinical training.
• Establish Clinic Health Education Resource Centers at the Velykiy Berezny FMC and the WWC in Uzhgorod.

1999

• The partners signed a Memorandum of Understanding on October 14.

• The Velykiy Berezny Family Medicine Clinic (FMC), a model primary care clinic, opened on December 5 and serves a rural population of 12,000.
• The Uzhgorod Women's Wellness Center (WWC) opened at the Uzhgorod Oblast Hospital on December 5 and serves the female population of Zakarpatska oblast.

• The partners hosted a Family Medicine Conference in Uzhgorod on September 19-21. Over 300 physicians from throughout Ukraine attended the conference.

• In May, the partnership sponsored a nursing conference in Velykiy Berezny attended by approximately 50 nurses from the Zakarpatska Oblast. The conference, led by US and Ukrainian faculty, focused on diabetes patient education, adolescent health, community outreach and improving the role of the nurse.
• In June, the partners held a Healthy Lifestyles Conference where they unveiled the healthy lifestyles curriculum for schoolchildren to teachers from Velykiy Berezny and Uzhgorod.
• A Family Medicine Training Clinic (FMTC) opened at Uzhgorod State University on October 15.
• In October, the partners hosted a roundtable discussion on healthcare financing.

• The partnership established the AIHA Cross-Partnership Smoking Prevention Coalition. The Coalition was established during a three day Cross-Partnership Conference "Healthy Lifestyles-Healthy Communities", hosted by the Uzhgorod-Corvallis Partnership and conducted in Uzhgorod, October 15-17.

• Two dental clinics were opened at the Uzhgorod University Family Medicine Training Clinic on March 19.
• A follow-up Cross-Partnership Workshop title "Healthy Lifestyles-Healthy Communities" was hosted by the partnership in Uzhgorod, May 6 and 7.

Primary Care

• The Velykiy Berezny Family Medicine Clinic (FMC) serves the rural population of approximately 9500 individuals of Velykiy Berezny. All six of the FMC's physicians were retrained at Uzhgorod State University, Oregon Health Sciences University, and various family medicine clinics in Corvallis.
• The Family Medicine Center opened at the Uzhgorod University provides services to 140 families.
• At the Family Medicine Conference hosted by the partners hosted in September 2001, over 300 physicians from throughout Ukraine were exposed to healthcare financing models, had an opportunity to discuss family physician training and curriculum, the nurse's role in family medicine, as well as share ideas about the features that identify the best family medicine model for Ukraine.
• A physician from the Velykiy Berezny FMC received the Best Family Physician Award at the First Ukrainian Congress of Family Physicians held in L'viv in November 2001. The conference, sponsored by the Ukrainian Ministry of Health and AIHA, served as a forum for policy makers, family practitioners, medical faculty, and researchers to discuss the current and future status of family medicine in Ukraine.
• Information management systems were developed for the FMC and WWC. The implementation of the systems streamlined data collecting procedures and facilitated reporting of data.
• Uzhgorod partners organized and conducted a round table discussion which was attended by medical professionals from Poland, Ukrainian regions of Ivano-Frankivsk, Chernivtsi, Zakarpattia, and Kiev, and various AIHA partnership sites. Participants of the discussion defined and prioritized the challenges and barriers to financial sustainability of family practice centers, identified ways to overcome these barriers, and developed short and long-term implementation strategies. The strategies were later implemented by partners in Velykiy Berezny and Uzhgorod.
• The number of referrals to specialists at the Velykiy Berezny FMC decreased from 53% at the time of the opening of the Center to 27% in May 2004.

Women's Health

• The Uzhgorod Women's Wellness Center (WWC) was established at the Zakarpatska Oblast Hospital after the partners had surveyed approximately 350 women on their health needs and analyzed the results of the survey. According to the survey results only 213.78 women per 1000 women of reproductive age used contraceptives. Other key findings that were identified as important indicators of the need for the center included infertility and recurrent miscarriages, insufficient rate of identification of sexually transmitted diseases, growth of the rate of medical problems among women of reproductive age, a need in psychological care, late identification of pelvic and breast cancers and lack of screening and educational programs.
• The WWC provides a comprehensive range of women's health services that focus on breast health, STIs, gynecological cancers, and healthy lifestyles choices for women.
• The WWC in Uzhgorod serves 594,174 women, including 302,609 of reproductive age. On overage 500 visits are registered at the Center each month.
• WWC staff regularly held classes for adolescents on contraception, STIs, HIV/AIDS prevention and family planning. The classes are held twice a week for a group of about 25 adolescents.
• The Uzhgorod WWC also serves as a family planning center providing in increased awareness of modern means of contraception among the population.

Community Health

• Three community health coalitions were formed in Uzhgorod and Velykiy Berezny focusing on health education in schools, community trust of physicians and managing the community health education resource centers.
• The partnership established health education resource centers at the Uzhgorod WWC, the Uzhgorod University FMTC, and the Velykiy Berezny FMC. The resource centers serve the community by ensuring access to health education information and provide a meeting place for health related community meetings.
• A Peer Education program was implemented in Velykiy Berezny and Uzhgorod. Two peer education groups in Velykiy Berezny work with 1,200 students on healthy lifestyles.
• After observing the traffic conditions children contend with on their walk to school, the partners launched a road safety campaign, "Reflect-a-Life." Staff from the Velykiy Berezny FMC administered a road safety survey among area youth. The survey results were used to create road safety curricula to support parents and educators in teaching children about road safety. The partners also distributed red reflectors to children to wear or attach to their book bags.
• The partners surveyed school children in Velykiy Berezny to assess risky behaviors. The results of this survey were used to develop a healthy lifestyles curriculum for teachers. In June 2002, the partners held a Healthy Lifestyles Conference where they unveiled the curriculum to teachers from Velykiy Berezny and Uzhgorod. The Curriculum focused on prevention of substance and tobacco abuse, responsible sexual behavior, good nutrition, physical activity and mental health.
• Fifty teachers and 400 school children participated in a smoking cessation program. As a result of this program, one school and a college in Velykiy Berezny are classified as non-smoking and 120 students and teachers do not smoke.
• An Uzhgorod and Velykiy Berezny Youth Smoking Prevention Coalition, including a broad range of community members, was formed in the fall of 2002 to raise awareness of the dangers of smoking. As part of their Youth Smoking Prevention Campaign, the coalition formed an anti-smoking peer mentor group.
• The partners established the AIHA Cross-Partnership Smoking Prevention Coalition, comprised of representatives from the seven West NIS PHC partnerships. Its members conducted community-wide youth smoking knowledge, attitudes and practices survey in December 2003. During the May 2004 follow-up workshop participants shared results of youth smoking surveys as well as antismoking campaigns and other activities conducted in their communities. The members of AIHA Cross-Partnership Youth Smoking Prevention Coalition have agreed to collaborate on further activities aimed at smoking prevention among youth.

Dentistry

• The partners established fully equipped dental facilities at the Uzhgorod University FMTC and the Velykiy Berezny FMC. A pediatric dental clinic provides services for the children of the city including orphans and disabled children. The second clinic provides much-needed dental services to the community's adult population.
• The partners initiated a dental education and prevention program at the boarding school in Velykiy Berezny that includes a fluoride rinse program for the children at the boarding school. Dental prevention program resulted in 28% decrease in the number of children with caries from 2001 to 2004.

Medical Education

• A Family Medicine Training Clinic (FMTC) opened at Uzhgorod State University on October 15, 2002. The FMTC is a model family medicine clinic that is staffed with qualified instructors to train family physicians. In addition to serving the general population in the University neighborhood, the clinic also focuses its services on the student population of Uzhgorod State University.
• A skills lab for residency training was established at Uzhgorod FMTC. This lab is designed to teach and assess clinical skills and communication skills for medical students and residents. The lab is equipped with two cameras to record the FP trainee working with patients. TV/VCR equipment is installed in an adjacent room to evaluate the trainees' performance.