Page 26 - Unlocking innovation

2.1
human resources Work Under an integrated health-care delivery in Armenia
Building better health-care from the bottom up
the challenge
reforming health services and increasing coverage in Armenia Armenia’s health service is plagued by low-quality service delivery, poor responsiveness to patient needs, and inadequate systems for facilities licensing and continuing education of health-care workers. Health-care is publicly funded, but curative care is only provided free of charge to the poor, vulnerable, and special categories, including children below the age of 7 years. Co-payments are typically 50% of the cost, far above the maximum 30% threshold that
is considered essential to ensure universal health coverage. Although there is a nationwide electronic medical records system in place, patient data collection mechanisms are weak and not integrated.
the innovation
evidence-informed decisions to get social health insurance right
Through an innovation pilot, ADB worked with Armenia’s Ministry of Health to map future trends in human resources for health: although there is currently a surplus of doctors, for example, the aging population will mean that many doctors will reach retirement just as the population’s health-care needs increase. Armenia will face a shortage, not a surplus, unless
it plans for its future human resources for health needs in advance.
ADB developed two dynamic tools to help ensure the ministry is making evidence-informed planning decisions, one for human resources for health and the other an actuarial tool for overall health-care nancing. The tools are both Excel-based, meaning every calculation is visible, and there are no “black box” features. Ministry sta were also trained to use such decision tools.
ADB provided international and national expert technical assistance to analyze the rationalization e orts in Armenia in the past 7 years, as well as analyze the primary health-care, hospital services, and the health workforce demands. Norms from Baltic states and other countries in the region, such as on the optimal number of doctors per 1,000 population, gave the government helpful points of comparison, and a study tour to Estonia helped them determine priorities for Armenia’s health system.
Action Update: What worked and what didn’t for ADB’s rst innovation regional technical assistance project
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