National Scale-Up of Results-Based Financing in Primary Health Care: The Case of Armenia

Petrosyan, Varduhi; Melkomian, Dzovinar Melkom; Zoidze, Akaki; Shroff, Zubin Cyrus

doi:10.1080/23288604.2017.1291394

Cited by 6 publications

(9 citation statements)

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“…It covers all primary healthcare facilities in the country and consists of two components: open enrollment and pay for performance (P4P). Through the P4P component, PHPs receive bonus payments based on their performance with respect to 27 indicators (Petrosyan et al ., 2017). Our participants shared that they were receiving financial benefits for performing activities to change their patients’ health behaviors such as alcohol and substance abuse, physical activity, dietary habits, and smoking, thought they did not receive bonus payments for providing smoking cessation counseling separately.…”

Section: Discussionmentioning

confidence: 99%

“…Consistent with the study carried out across 11 European countries, our findings suggest that lack of reimbursement for providing smoking cessation was considered as a major barrier (Young and Ward, 2001; Brotonsc et al ., 2005). In 2015, results-based financing has been integrated into the Armenian national health care financing system (Petrosyan et al ., 2017). It covers all primary healthcare facilities in the country and consists of two components: open enrollment and pay for performance (P4P).…”

Section: Discussionmentioning

confidence: 99%

“…Smoking is also remarkably prevalent among Armenian physicians (48.5% of males, 12.8% of females) and medical students (50.0% of males, 7.7% of females) (Perrin et al ., 2006). In 2015, primary healthcare (PHC) services in Armenia were delivered through 363 public and 141 private/other PHC units (Petrosyan et al ., 2017). Public PHC units include urban polyclinics, health centers, and rural ambulatory facilities that work with 552 small centers (called FAPs [Feldsher Acousher Posts]) run by nurses or midwives who are supervised by physicians from a nearby larger PHC unit and legally belong to that unit.…”

Section: Introductionmentioning

confidence: 99%

“…Public PHC units include urban polyclinics, health centers, and rural ambulatory facilities that work with 552 small centers (called FAPs [Feldsher Acousher Posts]) run by nurses or midwives who are supervised by physicians from a nearby larger PHC unit and legally belong to that unit. PHC services are fully publicly funded for all Armenian citizens (Petrosyan et al ., 2017). Armenia was the first former Soviet Union country to accede to the WHO/FCTC and soon after, Armenia adopted a national tobacco control law to ban smoking in healthcare, education, and cultural facilities, as well as public transportation (Framework Convention on Tobacco Control, 2011).…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Perceived barriers of tobacco dependence treatment: a mixed-methods study among primary healthcare physicians in Armenia

Harutyunyan

Abrahamyan

Hayrumyan

et al. 2018

Prim Health Care Res Dev

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BackgroundDespite compelling evidence that physicians play a prominent role in smoking cessation, most smokers do not receive the recommended smoking cessation counseling.AimTo identify perceived barriers that hinder primary healthcare physicians (PHPs) from providing smoking cessation treatment to patients in Armenia.MethodsA sequential exploratory mixed-methods study was conducted among PHPs from two Armenian cities (Yerevan and Gyumri). We implemented qualitative phase through focus group discussions (FGDs) using a semi-structured guide. For the subsequent quantitative phase, the data were collected through cross-sectional survey. A directed deductive content analysis technique was used to analyze the FGDs and questionnaires were analyzed descriptively. Following the data collection (March 2015–May 2016) and descriptive analysis, the qualitative and quantitative data sets were merged by drawing quantitative data onto qualitative categories.FindingsOverall, 23 PHPs participated in five FGDs and 108 participants completed the survey. Three main categories of barriers were identified: physician-based, patient-based, and system-based barriers. The main physicians-based barriers were insufficient knowledge and inadequate training on tobacco-dependence treatment. Lack of patients’ motivation to quit, poor compliance with the treatment, patients’ withdrawal symptoms were identified as patient-based disincentives. System-based barriers included lack of reimbursement for providing smoking cessation counseling, high price and low availability of smoking cessation medications. Most of the qualitative descriptions were confirmed by quantitative findings.ConclusionsTargeted interventions are needed to address barriers that limited PHPs’ involvement in providing smoking cessation services in Armenia. There is an urgent need to enhance PHPs’ knowledge and skills in delivering smoking cessation counseling, to increase patients’ demand for smoking cessation services, and to ensure availability and affordability of smoking cessation services in Armenia.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Perceived barriers of tobacco dependence treatment: a mixed-methods study among primary healthcare physicians in Armenia

Harutyunyan

Abrahamyan

Hayrumyan

et al. 2018

Prim Health Care Res Dev

Self Cite

View full text Add to dashboard Cite

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“…Among other efforts, Armenia has modernized its primary care network, enforced tobacco control, and instituted state of the art cardiac and stroke care. [5][6][7][8] Like many middle-income countries, Armenia had challenges controlling the spread of coronavirus disease 2019 (COVID-19). There was a lack of personal protective equipment, a lack of ventilators, and a lack of testing.…”

mentioning

confidence: 99%

Violation of the Global Ceasefire in Nagorno-Karabagh: A Viral Amplification of Aggression

Chekijian

Bazarchyan

2021

Prehosp. Disaster med.

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On March 23, 2020, the United Nations (UN) made an Appeal for a Global Ceasefire following the Outbreak of Coronavirus. Despite this appeal, the Nagorno-Karabagh war was instigated on September 27, 2020. This Guest Editorial frames the conflict in the context of the UN appeal and by introducing a figure that plots seven-day average coronavirus disease 2019 (COVID-19) cases overlaid with key inflection points to illustrate the clear impact that conflict has had on pandemic spread in Armenia. The conflict in Nagorno-Karabagh provides a timely, concise, and illustrative example of conflict and its impact on health. Finally, an argument is made that the ability to enforce the UN Appeal for a Global Ceasefire is essential to ensure global health and security.

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Is Performance-Based Financing A Pathway to Strategic Purchasing in Sub-Saharan Africa? A Synthesis of the Evidence

Waithaka

Cashin

Barasa

2022

Health Systems & Reform

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Many countries in sub-Saharan Africa have implemented performance-based financing (PBF) to improve health system performance. Much of the debate and analysis relating to PBF has focused on whether PBF “works”—that is, whether it leads to improvements in indicators tied to incentive-based payments. Because PBF schemes embody key elements of strategic health purchasing, this study examines the question of whether and how PBF programs in sub-Saharan Africa influence strategic purchasing more broadly within country health financing arrangements. We searched PubMed, Scopus, EconLit, Cochrane Database of Systematic Reviews, Google Scholar, Google, and the World Health Organization and World Bank’s repositories for studies that focused on the implementation experience or effects of PBF in sub-Saharan African and published in English from 2000 to 2020. We identified 44 papers and used framework analysis to analyze the data and generate key findings. The evidence we reviewed shows that PBF has the potential to raise awareness about strategic purchasing, improve governance and institutional arrangements, and strengthen strategic purchasing functions. However, these effects are minimal in practice because PBF has been introduced as narrow, often pilot, projects that run parallel to and have little integration with the mainstream health financing system. We concluded that PBF has not systematically transformed health purchasing in countries in sub-Saharan Africa but that the experience with PBF can provide valuable lessons for how system-wide strategic purchasing can be implemented most effectively in that region—either in countries that currently have PBF schemes and aim to integrate them into broader purchasing systems, or in countries that are not currently implementing PBF. We also concluded that for countries to pursue more holistic approaches to strategic health purchasing and achieve better health outcomes, they need to implement health financing reforms within or aligned with existing financing systems.

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National Scale-Up of Results-Based Financing in Primary Health Care: The Case of Armenia

Cited by 6 publications

References 9 publications

Perceived barriers of tobacco dependence treatment: a mixed-methods study among primary healthcare physicians in Armenia

Perceived barriers of tobacco dependence treatment: a mixed-methods study among primary healthcare physicians in Armenia

Violation of the Global Ceasefire in Nagorno-Karabagh: A Viral Amplification of Aggression

Is Performance-Based Financing A Pathway to Strategic Purchasing in Sub-Saharan Africa? A Synthesis of the Evidence

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