AIHA Primary Healthcare Initiative

“Given the current budgetary constraints that we are all feeling at local, national, and international levels, it is even more imperative to focus on primary care and prevention programs. The bridges and relationships we have built through our AIHA partnership with Tomsk are invaluable tools for creating a safer, more caring, global community.”

Mary Thompson, public health nurse and US partnership coordinator (Tomsk, Russia/Bemidji, Minnesota, and Engels, Russia/Bemidji, Minnesota, partnerships)

In an era when poor lifestyle choices are resulting in swiftly increasing rates of chronic disease, disability, and behavioral health concerns the world over, the age-old adage “An ounce of prevention is worth a pound of cure” is more relevant that ever before. In developed and developing countries alike, more and more deaths are attributed to largely preventable causes, including cardiovascular disease, cancer, and accidental injuries or poisoning.

AIHA partnerships and programs are working to change this by offering a broad range of community outreach and education services that help advance public health initiatives while at the same time promoting individual responsibility. By mobilizing various sectors of the community—including politicians, civic leaders, clergy, educators, and healthcare providers, as well as representatives of differing ages and socio-economic groups—AIHA’s community-based partnerships and programs are able to assess local needs and available resources then set priorities for targeting the health-related issues of greatest concern to the population.

Whether the goal is to address health concerns specific to an individual population, improve public awareness of health issues through education and outreach, or broaden the scope and accessibility of preventive screening and other clinical services, the success of these community-based alliances clearly illustrates that people are eager to play a more active role in improving both their individual health as well as that of their community. A financial benefit of this approach is that it supports a key health reform goal of many countries by helping them transition from a system heavily dependent on tertiary care to one that emphasizes primary care, prevention, and personal responsibility.


AIHA’s efforts to improve the scope and availability of high-quality primary care services through specific programmatic activities include:

Primary Healthcare Partnerships

With funding from the US Agency for International Development, AIHA began establishing and managing a network of primary healthcare partnerships in Eastern Europe and Central Asia in 1998. Through training—and sometimes the re-training—of clinicians, the goal of these partnerships is to ensure that people of all ages have access to comprehensive, continuous, and coordinated care.

Through a network of more than 30 primary healthcare partnerships in Eastern Europe and Central Asia, AIHA has helped establish some 70 primary care, family medicine, and women’s wellness centers that provide comprehensive, high-quality clinical care to thousands of people each year.

  • Ganja (Azerbaijan)/Livermore (California)
  • Gori (Georgia)/Milwaukee (Wisconsin)
  • Guria (Georgia)/La Crosse (Wisconsin)
  • Armavir (Armenia)/Galveston (Texas)
  • Ashgabat (Turkmenistan)/North Dakota
  • Astana (Kazakhstan)/Pittsburgh (Pennsylvania)
  • Baku (Azerbaijan)/Portland (Oregon)
  • Baku (Azerbaijan)/Richmond (Virginia)
  • Bishkek (Kyrgyzstan)/Tampa (Florida) and Reno (Nevada)
  • Chisinau (Moldova)/Norfolk (Virginia)
  • Donetsk and Kramatorsk (Ukraine)/Pittsburgh (Pennsylvania)
  • Dushanbe (Tajikistan)/Boulder (Colorado)
  • Gegarkunik (Armenia)/Providence (Rhode Island)
  • Gjilan (Kosovo)/Hanover (New Hampshire)
  • Kharkiv (Ukraine)/La Crosse (Wisconsin)
  • Kiev (Ukraine)/Philadelphia (Pennsylvania)
  • Kurgan and Schuche (Russia)/Appleton (Wisconsin)
  • L’viv (Ukraine)/Cleveland (Ohio)
  • Lezha (Albania)/Pittsburgh (Pennsylvania)
  • Lori (Armenia)/Los Angeles (California)
  • Lori (Armenia)/Milwaukee (Wisconsin)
  • Mtskheta-Mtianeti (Georgia)/Milwaukee (Wisconsin)
  • Odessa (Ukraine)/Boulder (Colorado)
  • Samara and Stavropol (Russia)/Iowa
  • Sarov (Russia)/Los Alamos (New Mexico)
  • Snezhinsk (Russia)/Livermore (California)
  • Tomsk (Russia)/Bemidji (Minnesota)
  • Uzhgorod (Ukraine)/Corvallis (Oregon)
  • Volgograd (Russia)/Little Rock (Arkansas)
  • Yerevan (Armenia)/Boston (Massachusetts)
  • Yerevan (Armenia)/Washington (District of Columbia)

Practitioner/Care Giver Training

Whether it’s through partnership programs, professional exchanges, skills-based clinical courses, or curriculum development, training healthcare providers, policymakers, and other caregivers is at the very heart of AIHA’s HIV/AIDS programs. Designed to effectively transfer skills, knowledge, and technology, these training programs focus on long-term, sustainable results by helping to develop national and regional faculty who can pass what they have learned on to others.

Training—and in some cases re-training healthcare workers who specialized in other clinical disciplines—is a critical element of AIHA’s approach to building health system capacity in transitioning and resource-constrained settings.

Community-oriented Primary Care

The goal of AIHA’s Community-oriented Primary Care Program is to provide high-quality, integrated medical and social services to all segments of a particular population. Meeting the needs of vulnerable and often underserved groups such as children, the elderly, and individuals with physical or mental disabilities is a key objective of this holistic model of care. Read more…

AIHA’s Community-oriented Primary Care Program in Kazakhstan is based on the highly effective socio-medical model piloted at Demeu Family Medicine Center in the nation’s capital of Astana. This Center was established in November 2000 through the efforts of the Astana/Pittsburgh partnership.

Demeu’s approach encompasses the principles of primary care, epidemiology, and public health to effectively integrate delivery of medical care with social services that address defined community needs, in particular the needs of high-risk segments of the population.

Improvements in the quality of health-related services available in Astana following Demeu’s opening—along with related improvements of health indicators among the local population—convinced the Kazakh Ministry of Health and Ministry of Labor and Social Welfare to support the replication of the community-oriented primary care model throughout Kazakhstan.

The goal of the replication project launched in 2004 is to scale up the Demeu model in selected communities within Kazakhstan by promoting adoption of Demeu’s positive features, especially its approach to serving vulnerable groups and addressing social problems that impact the health status of the population it serves.

In close collaboration with AIHA and USAID, staff from Demeu are spearheading the process of training and mentoring health and allied professionals at clinics in Almaty, Semey (formerly known as Semipalatinsk), and Uralsk. The Pittsburgh partners provide a limited amount of technical assistance and Columbia University School of Social Work has played an important role in the development and implementation of a Social Work Training Center that now operates at Demeu.

Key objectives of the replication project in Kazakhstan are to:

  • develop social work as a profession by strengthening the training capacity of the Demeu Family Medicine Center to better integrate a socio-medical model in primary care throughout the country;
  • engage local and oblast-level health administration in target regions (Almaty, Semey, and Uralsk) along with representatives of family group practices in planning and implementing activities designed to foster use of an integrated socio-medical model in primary healthcare;
  • improve the delivery of primary healthcare services through the integration of social services at selected replication sites; and
  • sustain improvements made in primary healthcare services at replication sites through the development of quality improvement practices.