Evaluation plan for primary medical care improvement program in seven villages of Masis region

Abstract

Based on the Primary Medical Care National Health Reform program (developed in 1996) primary medical care in Armenia will be improved in the following ways. 1.Training of primary health care providers (PHCP)., which will include a) training of general practitioners at the State Medical University ( SMU); b) retraining of district therapeutists, district pediatricians, midwives and district nurses at the National Institute of Health (NIH) and c) the training of nurse practitioners and midwives at the Nurse College (NC) #1 (which is the methodological center for other NCs). 2.Rehabilitation and maintenance of the primary health care (PHC) facilities by renovation of health units, provision of equipment, medical supplies, essential drugs etc. 3.Development of clinical practice guidelines for family practice. Some non- governmental organizations (NGOs) carry out pilot programs in this area (in PHC or/and in PMC), coordinated by Ministry of Health of Armenia. United Methodist Committee on Relief (UMCOR) non-governmental organisation started primary medical care improvement pilot program in August 1997 in seven villages of Masis region: Hayanist, Khachpar, Darbnik, Zorak, Ranchpar, Noramarg, SayatNova. Goal of the program is to improve healthstatus of population living in seven villages of Masis region by decreasing morbidity, mortality and disability. The program implementation includes: maintenance and rehabilitation of health care units (renovation and reconstruction of those HUs), provision of equipment and medical supply, retraining of middle level health care providers and establishment of revolving drug fund. Evaluation of improvement of primary medical care (PMC) in those target villages will be based on the specific assessment criteria. This paper is focused on the evaluation of the performance skills (for diarrhoea management) of pediatric nurses at the primary health care level. This program hopes to improve case management performed by pediatric nurses. Five objectives detailed below will be evaluated according to the evaluation plan. All these five objectives are important, but the purpose of this paper is to give detailed description of evaluation plan for objective 4. To achieve that objective three-month special retraining courses will be organized. One month before program implementation assessment of performance of pediatric nurses (pretest) by record review was made. After six months of program implementation the second assessment (post test) will be made and the results of two assessments will be compared. Analys is of the program will be based on estimation of statistical significance. The study power is calculated.