Equal access to primary health care, health promotion and preventive services with the help of EEA Grants

The primary health services strengthening project was more than an investment in the health of the communities included in the project. It is, in fact, an investment in the health of the country as a whole because, at the heart of a community, health is the foundation that sustains every individual and therefore the entire society.

Entitled "Strengthening the national network of primary health care providers to improve the health status of the population, children and adults (including vulnerable population)" the project was launched on September 25th, 2020, under the coordination of the National Institute of Public Health (INSP/NIPH).

Implemented with the support of EEA Grants 2014 - 2021, the project will remain an example of good bilateral collaboration between entities from Romania and Norway, having a significant impact on the targeted communities.

In the effort to improve equal access to primary health care services, the initiative brought together institutions with proven experience and expertise, such as the Norwegian Institute of Public Health, the Norwegian Directorate of Health, the Alessandrescu-Rusescu National Institute for Mother and Child Health and the World Health Organization (WHO), Country Office for Romania. This collaboration involved expertise and resources from all partners to create sustainable change in the public health sector.

The main strategic directions of intervention were: improving the evidence for the development of health policies at the local and national level and strengthening the health information system and capacities at the level of primary health care, with an emphasis on community health care, family medicine and school health care.

"This project aimed to carry out 27 complex activities that were implemented simultaneously in several regions of the country, and for which the financial effort could not have been covered only from national sources, the role of supporting the Grants being a crucial one. Among the actions of the project, I would emphasize the importance of the European survey regarding the health of the community, based on a methodology already applied in 15 other countries", explained Alexandra Cucu, Primary Physician, University Lecturer, National Institute of Public Health.

In fact, the project continued to build on the results of previous projects implemented by INSP/NIPH and funded by Norwegian Grants 2009 – 2014 under the RO Program 19 Initiatives in the field of public health.

E-Learning platform, practice guides and essential support manuals for community healthcare providers

In order to strengthen the national network of primary health care providers, a series of tools have been developed that improve the practice of providing community healthcare services, with a focus on preventive services.

Thus, the following were developed: Practice guidelines (with the algorithm of preventive interventions for the priorities identified at community level and recommendations regarding eating habits, smoking, alcohol consumption, physical activity, as well as the main prevalent chronic diseases of diabetes, oral health, breastfeeding, child development and wound care); Manual for community nurses with topics of interest for current practice (infectious diseases in children, trauma and domestic accidents, chronic diseases in adults, etc.); The Guide to Reproductive and Sexual Health in Young People.

These were capitalized by displaying them on the E-Learning platform developed in the project, which addresses family doctors, community nurses, school nurses and staff of Public Health Directorates.

Local health profile based on the Norwegian model

The project brought together and established a collaboration between public health specialists with family doctors, doctors and staff from Public Health Directorates and doctors from clinical specialties, to develop useful tools for current practice in primary health care. It was also an opportunity to exchange experience and collaborate between Romanian and Norwegian specialists and international teams of WHO experts.

Children from vulnerable categories were part of the target group of the INSP/NIPH project.

"We made the health profile of the local community, following a Norwegian model that gave us information about the health level of the community, what are the health problems in a certain region and how priorities should be set in order to apply solutions", stated Alexandra Cucu, Primary Physician, University Associate, National Institute of Public Health.

With a focus on improving equal access to primary, preventive healthcare services provided in communities and in family doctors` offices, this project overlapped with the European Union`s health objectives.

The initiative generated a revival of equal access to Primary Health Care services, through the integration of services provided and the promotion of health and preventive services, and was built on the results of previous projects.

Actions in the community and equal access to community services were prioritized.

The practical translation of the recommendations from the guidelines could be implemented through preventive consultations integrated in 100 family doctors` offices from the target communities of the project as well as from other communities, carried out with the help of Prevent IT, including the updated sheets of the guidelines, but also the developed in the project (eg: reproductive health, oral health, iron deficiency anemia, prenatal care, rickets, accidents in the elderly, cancer, cardiovascular diseases, nutrition, physical activity, tobacco and alcohol consumption).

84 Info-Points within the Community Medical Centers

A series of Info Points were created in 84 localities, within the Community Medical Centers from 7 counties (Botoșani, Călărași, Dolj, Giurgiu, Gorj, Neamț, Suceava). They provide the beneficiaries with useful information about the rights of the uninsured, the rights of the co-insured, the route of the patients, etc.
Also from the scope of intervention tools at the local level, a model for annual planning of Community Medical Assistance activities was developed as a pilot in seven localities, to be made available to the Ministry of Health.

The impact of the initiative was as big as the funding provided by the EEA Grants

With a total value of over 42 million lei, the project demonstrated the importance of the funding provided by the EEA Grants, addressing the local community directly by creating equitable access to primary healthcare services. Last but not least, health and the importance of prevention services were promoted among the population through the activities implemented and the results obtained.

The EEA and Norway grants represent the contribution of Iceland, the Principality of Liechtenstein and the Kingdom of Norway to reducing economic and social disparities in the European Economic Area and to strengthening bilateral relations with the 15 beneficiary states in Eastern and Southern Europe and the Baltic states.

These financing mechanisms are established on the basis of the Agreement on the European Economic Area, which brings together the EU member states and Iceland, Liechtenstein and Norway as equal partners in the internal market. In total, the three states contributed 3.3 billion euro between 1994 and 2014 and 2.8 billion euro for the 2014-2021 funding period.

Further details can be found on: www.eeagrants.ro and www.eeagrants.org.