YEREVAN, Armenia– In April 2017, the Health Systems and Reform, an open access peer-reviewed international journal, published the article “National Scale-Up of Results-Based Financing in Primary Health Care: The Case of Armenia”, which looked into the interaction of contextual factors, actors, and processes that contributed to the successful scale-up and integration of result based financing (RBF) to Armenia’s primary health care system. Drs. Varduhi Petrosyan and Dzovinar Melkom Melkomian (MPH ‘11) from the Gerald and Patricia Turpanjian School of Public Health (SPH) led the work on this article.
The article looks at the description of the Armenian health system and the RBF program, provides an overview of the data sources and methods, and describes the process of evolution and policy implementation related to RBF in Armenia from initial piloting in one region to the national scale-up over the period 2000-2015.
This article was written as a result of a comprehensive document review and qualitative data collection through in-depth interviews (IDIs) and focus group discussions (FGDs) with 76 individuals (67 women and nine men) including policy makers, local and international experts, facility managers, primary health care physicians and nurses. Documents explored included policies, laws and regulations, project reports and presentations, and published articles.
The well-sequenced reform process included the most important stakeholders, particularly the State Health Agency – the purchasing agency of the Ministry of Health, since day one. The United States Agency for International Development (USAID) supported projects introduced and developed the initial design of the RBF scheme in Armenia, which was embraced by the national policy makers from the beginning as an innovative solution that could improve the performance of primary health care providers and utilization of PHC services. An important factor contributing to the national scale-up and integration of RBF into the PHC system was “its introduction as part of a larger reform of the primary health care system” in Armenia. This paper has important lessons for other low- and middle-income countries on how to successfully apply RBF schemes in increasing utilization of desired services.
Petrosyan V, Melkom Melkomian D, Zoidze A, Shroff ZC. National Scale-Up of Results-Based Financing in Primary Health Care: The Case of Armenia. Health Systems and Reform 2017 Vol. 3, No. 2, 117-128, 16:945. DOI: 10.1080/23288604.2017.1291394
The World Health Organization’s Alliance for Health Policy and Systems Research provided funding for this project. SPH worked with Curatio International Foundation Georgia on this project.
The AUA Gerald and Patricia Turpanjian School of Public Health works actively to improve population health and health services in Armenia and the region through interdisciplinary education and development of public health professionals to be leaders in public health, health services research and evaluation, and health care delivery and management.