Stakeholder Meeting on COVID-19 Experiences of Primary Healthcare System

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YEREVAN, Armenia — The American University of Armenia (AUA) Fund, in collaboration with the Ministry of Health of the Republic of Armenia, is implementing the United States Agency for International Development (USAID)-funded project, Support to Control COVID-19 and Other Infectious Disease Outbreaks. The project is working to strengthen Armenia’s national capacity to control COVID-19 and other communicable disease outbreaks and emergencies of potential public health concern. The work undertaken through this project is aligned with and directly contributes to advancing the government’s Public Health Emergency Preparedness and Response Strategy.

On December 17-18, 2021, the Avedisian Onanian Center for Health Services Research and Development (CHSR) of the AUA Turpanjian College of Health Sciences (CHS) led a two-day stakeholder meeting on “The Experiences of the Primary Health Care (PHC) in Armenia during the COVID-19 Pandemic and Development of Recommendations for PHC Strengthening.” The meeting convened 26 representatives from different stakeholder organizations, including national and local level policymakers, managers, and providers from PHC facilities of Yerevan and various regions of Armenia. During the meeting, CHSR shared the findings from a comprehensive assessment it had conducted of the PHC system’s response to the COVID-19 pandemic in Armenia. The event also served as a platform to discuss opportunities to strengthen the PHC system, so that it is better able to tackle the current pandemic and future outbreaks of public health importance.

The assessment examined experiences of the PHC system during the COVID-19 pandemic from the perspective of multiple stakeholders including policymakers, facility managers, PHC providers, and patients. It has revealed strengths and gaps in the response of the healthcare system. The PHC system went through significant changes and transformations, including intensive training of healthcare providers, development of the national guidelines for COVID-19 outpatient management, as well as equipment enhancement of PHC facilities. However, major issues, such as overuse of medication (including antibiotics and anticoagulants) and diagnostic tests (including computer tomography scan) for outpatient management of COVID-19 patients and consequential financial burden remain unresolved. 

The assessment has shown that there is a lack of knowledge among PHC providers of evidence-based COVID-19 treatment protocols, and of the benefits of vaccination. As a result, PHC’s ability to control the pandemic has been hindered. The assessment also revealed that rural communities were adversely affected by poor access to diagnostic resources, including PCR testing. Provision of essential health services in PHC facilities underwent some changes during the pandemic. Preventive visits for gynecological and pediatric services were stopped and only patients with urgent needs were served, most of the pediatric services were provided during home visits, and pregnant women visited polyclinics only by appointment. Additionally, the assessment found that patients were fearful to visit polyclinics for non-COVID-19 related issues, and specialist doctors were not equipped with enough skills or knowledge of [WHAT] to most efficiently and accurately manage their patients’ health care needs. Compliance with infection prevention and control measures at PHC facilities were mostly adequate, despite the uncoordinated supply and inadequate use of personal protective gear by PHC providers and visitors.

The meeting concluded with the stakeholders’ feedback and commendation. Overall, all participants reported high satisfaction with the event. They expressed agreement with the findings from the CHSR study, the gaps identified at the PHC level in responding to the pandemic, and made recommendations for improvement of the PHC preparedness and response to public health emergencies. Reflecting on the positive aspects of the stakeholder meeting, one of the participants stated: “The presence of various stakeholders was an important aspect of the meeting. It helped to have an open and lively discussion, exchange ideas and experiences, and come up with realistic solutions.”

The meeting was adjourned with concluding remarks from participants and the CHSR team, emphasizing the importance of strengthening the PHC capacity and quality for efficient and sustainable solutions. The stakeholders also expressed their readiness and commitment for continued collaboration and input to enhance the preparedness of the PHC in Armenia for the COVID-19 pandemic and other infectious disease outbreaks. The CHS team submitted the summary reports about the PHC assessments to the Minister of Health and the relevant department at the ministry. The team is collaborating with the ministry to develop an action plan to strengthen the PHC system’s capacity for emergency preparedness and response.

The AUA Turpanjian College of Health Sciences 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, health care delivery, and management.