USAID Health Care Improvement Project (HCI) | Russia

Overview

HCI Russia partnered with major stakeholders from 2007 to 2011 in 1) the St. Petersburg and Orenburg oblasts to improve HIV/AIDS treatment, care, and support and develop social support services for HIV-affected families and 2) the Tver, Tula, Tambov, Kostroma, Yaroslavl, and Ivanovo oblasts to design and implement improvements in priority areas of maternal and child health (prevention of neonatal hypothermia, promotion of breastfeeding, use of the World Health Organization partograph for labor management, prevention of unwanted teen pregnancies and STIs, and primary neonatal resuscitation).  

HCI Russia cooperated with Russian partners to enhance capacities for improved HIV/AIDS prevention, care, and support in the Leningrad and Sverdlovsk oblasts and the Republic of Tatarstan. The project initiated a program in these areas to increase the early detection of TB and improve TB treatment outcomes in Saratov and Bryansk oblasts. It also began to reduce alcohol and tobacco use during pregnancy in the Tambov, Tver, and Tula oblasts.

Key Activities

Regional level

  • Collaborated with care providers and authorities in the Sverdlovsk and Leningrad oblasts and the Republic of Tatarstan to improve the delivery of HIV services and the prevention of HIV among most-at-risk populations and people living with HIV;
  • Helped care providers and health/social services authorities in St. Petersburg serve as a resource site for new regions joining the project;
  • Collaborated with St. Petersburg’s Committee on Social Policy to develop standards for social services for HIV-affected families;
  • Built the capacity of providers in the Saratov and Bryansk oblasts to detect and treat TB and refer patients to social services;
  • Supported the Saratov Medical University in establishing a training center to educate primary care providers detecting TB;
  • Collaborated with the Tula, Tver, and Tambov oblasts to train staff to counsel youth and pregnant women against tobacco and alcohol use.

Federal level

  • Helped federal agencies facilitate the nationwide promotion and adoption of best practices and organizational approaches to HIV-related care.
  • Supported TB research institutes in improving TB-related services.

Achievements
The project helped Russian counterparts:

  • Develop and implement recommendations for social services for HIV-affected families in St. Petersburg;
  • Develop and implement organizational guidelines for medical follow-up of HIV patients in St. Petersburg polyclinics;
  • Conceive a framework for engaging HIV care providers in St. Petersburg, Leningrad, and Sverdlovsk oblasts to systematically identify gaps in HIV care, treatment, and support and formulate priorities for improvement;
  • Develop healthquality.ru to enable the Center for Quality (of the Federal Research Institute for Health Care Organization and Informatics) in promoting quality improvement methods;
  • Develop four change packages on priority reproductive health topics, including prevention of hyperthermia, use of the partograph, prevention of unwanted pregnancies and STI among teens, and breast feeding; and
  • Establish educational activities with TB patients in TB dispensaries of Saratov and Bryansk oblasts to improve adherence to TB treatment

Results

Notes on major changes introduced:

LS I (Learning Session 1): Nine multidisciplinary municipal teams trained in quality improvement; problems identified; patients counseled on the need for a regular examination both by health care providers and social services psychologists; both newly detected and lost-to-care HIV patients searched for by visiting nurses and peer-to-peer consultants; referrals established between specialists and  services; social support services organized; weekly monitoring of patients established; efforts begun to bring in patients lost to care and/or who had dropped antiretroviral therapy; and training begun for providers in voluntary counseling and testing (VCT)

LS II (Learning Session 2): The AIDS Center selected 16 municipalities least advanced in coverage of HIV patients with regular medical exam; established and trained teams in quality improvement; nine teams shared their progress with new 16 teams; trained health and social service providers in VCT, initiated supervision; and some components of HIV prevention among people with HIV initiated in 25 municipalities

 

Duration
2007 to 2012
Funders 
US Agency for International Development (USAID)
Partners 
Ministry of Healthcare of the Russian Federation
Federal Research Institute of Health Organization and Informatics
Central Tuberculosis Research Institute
Institute of Phthisiopulmonology
Committee on Social Policy of St. Petersburg
Committee on Healthcare of Leningrad Oblast
Russia Sverdlovsk Oblast Ministry of Health
Russia Saratov Oblast Ministry of Health
Russia Saratov State Medical Academy
Regions/ Countries 
Geographic Scope 
The Republic of Tatarstan and eight oblasts (provinces): Sverdlovsk, Leningrad, St. Petersburg, Saratov, Bryansk, Tambov, Tver, and Tula