Rocky road from the Semashko to a new health model

Sheiman, Igor

doi:10.2471/blt.13.030513

Cited by 35 publications

(26 citation statements)

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“…The idea of collaboration within a PHC team as well as between teams did not correspond to the perspective intrinsic to the Semashko model predominating in these countries, which was characterized by centralisation and fragmentation of care. The Semashko model’s aspirations to provide universal health coverage free of charge resulted in financially burdened health systems due to weak PHC and an emphasis on in-patient care with high demand for specialists, little continuity and poor coordination of care [21]. Inter-professional collaboration eventually emerged as an issue, primarily during the health care reforms that followed the collapse of the Soviet Union [22-25].…”

Section: Introductionmentioning

confidence: 99%

Teamwork in primary care: perspectives of general practitioners and community nurses in Lithuania

et al. 2013

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BackgroundA team approach in primary care has proven benefits in achieving better outcomes, reducing health care costs, satisfying patient needs, ensuring continuity of care, increasing job satisfaction among health providers and using human health care resources more efficiently. However, some research indicates constraints in collaboration within primary health care (PHC) teams in Lithuania. The aim of this study was to gain a better understanding of the phenomenon of teamwork in Lithuania by exploring the experiences of teamwork by general practitioners (GPs) and community nurses (CNs) involved in PHC.MethodsSix focus groups were formed with 29 GPs and 27 CNs from the Kaunas Region of Lithuania. Discussions were recorded and transcribed verbatim. A thematic analysis of these data was then performed.ResultsThe analysis of focus group data identified six thematic categories related to teamwork in PHC: the structure of a PHC team, synergy among PHC team members, descriptions of roles and responsibilities of team members, competencies of PHC team members, communications between PHC team members and the organisational background for teamwork. These findings provide the basis for a discussion of a thematic model of teamwork that embraces formal, individual and organisational factors.ConclusionsThe need for effective teamwork in PHC is an issue receiving broad consensus; however, the process of teambuilding is often taken for granted in the PHC sector in Lithuania. This study suggests that both formal and individual behavioural factors should be targeted when aiming to strengthen PHC teams. Furthermore, this study underscores the need to provide explicit formal descriptions of the roles and responsibilities of PHC team members in Lithuania, which would include establishing clear professional boundaries. The training of team members is an essential component of the teambuilding process, but not sufficient by itself.

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Section: Introductionmentioning

confidence: 99%

Teamwork in primary care: perspectives of general practitioners and community nurses in Lithuania

et al. 2013

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“…The healthcare model as formulated after the 1917 coup (the Soviet healthcare system) was based on the six following principles 5 6 : the state’s responsibility for healthcare free healthcare for everyone special attention to maternity and childhood promotion of a healthy lifestyle, prevention and prophylaxis preventive treatment of socially significant diseases involving society into healthcare activities. …”

Section: Evolution Of the Russian Child Care System: From The Russianmentioning

confidence: 99%

Paediatrics in Russia: past, present and future

et al. 2017

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“…A move towards specialisation in outpatient care led to a much-reduced role of the district physician and direct access to specialist care, but this resulted in unmet demand for quality care. 23 At the same time, despite substantial reductions in the past decade, hospitalisation rates remain well above OECD levels. 24 Very soon after independence from the Soviet Union in 1991, private medical practice was allowed in Kazakhstan and the country started an ill-fated attempt to introduce mandatory health insurance (1996–1998).…”

Section: Context: Healthcare In Kazakhstanmentioning

confidence: 99%

Data for development in health: a case study and monitoring framework from Kazakhstan

et al. 2016

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Healthcare reforms are often not coupled with a relevant and appropriate monitoring framework, leaving policymakers and the public without evidence about the implications of such reforms.Kazakhstan has embarked on a large-scale reform of its healthcare system in order to achieve Universal Health Coverage. The health-related 2020 Strategic Development Goals reflect this political ambition. In a case-study approach and on the basis of published and unpublished evidence as well as personal involvement and experience (A) the indicators in the 2020 Strategic Development Goals were assessed and (B) a ‘data-mapping’ exercise was conducted, where the WHO health system framework was used to describe the data available at present in Kazakhstan and comment on the different indicators regarding their usefulness for monitoring the current health-related 2020 Strategic Development Goals in Kazakhstan.It was concluded that the country’s current monitoring framework needs further development to track the progress and outcomes of policy implementation. The application of a modified WHO/World Bank/Global Fund health system monitoring framework was suggested to examine the implications of recent health sector reforms. Lessons drawn from the Kazakhstan experience on tailoring the suggested framework, collecting the data, and using the generated intelligence in policy development and decision-making can serve as a useful example for other middle-income countries, potentially enabling them to fast-track developments in the health sector.

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Rocky road from the Semashko to a new health model

Cited by 35 publications

References 0 publications

Teamwork in primary care: perspectives of general practitioners and community nurses in Lithuania

Teamwork in primary care: perspectives of general practitioners and community nurses in Lithuania

Paediatrics in Russia: past, present and future

Data for development in health: a case study and monitoring framework from Kazakhstan

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