MANAGEMENT of the national program to prevent and control HIV/AIDS and STI for the 2011-2015 period...

MANAGEMENT

of the national program to prevent and control HIV/AIDS and STI for

the 2011-2015 period

Stefan Gheorghita

NPHC deputy head

June 27th, 2011

Legal frameworkNational Program-approved by GD 1143 of december 16th, 2010

(published in Official Monitor Nr. 254-256 of 24.12.2010)

Central public authorities are obliged :

- to create and approve operational plans for the implementation of National Program provisions

- to inform the Ministry of Health on an annual basis on the accomplishment of the program by March 5th

Municipal and district councils are reccomended to :

- create and approve territorial programs

- to insure the realisation of territorial programs

- to create territorial commissions for the prevention and control of HIV/AIDS and STI

Program Implementers: Government of the Republic of MoldovaMinistry of Health and relevant institutions Ministry of Labour, Social Protection and Family Ministry of EducationMinistry of Justice, Department of Penitentiary InstitutionsMinistry of Youth and Sports and relevant institutionsFirst and second degree local public authorities UN technical agencies (UNAIDS, WHO, UNFPA, UNICEF,

etc.) by providing technical and assistance and informing on international standards

National and international NGOs specialized in interventions, including the ones planned for PLWH

Government of the Republic of Moldova

Coordinating the measures of response to HIV and STIs for the 2011-2015 period

Developing NCC coordinating capacities in the accomplishment of the National Program

Strengthening networks of NGOs working in the fields of HIV/AIDS/STIs and with PLWH

Providing financing priority, political support for HIV/AIDS

Structure of the control system in HIV/AIDS, national and subnational level

Ministry of Health

Creating policies in the field of HIV/AIDSCoordinating response to HIV with central and local

authoritiesCoordination of prevention, treatment and support activities

carried-out by public and private healthcare institutions Creating strategies and plans of professional training the field

of HIV/AIDS and STIDeveloping and promoting in international organisations of

projects for financing and technical support in the field of HIV/AIDS/STI

Monitoring and evaluation

The scheme of interactions between medical institutions in the HIV/AIDS service provision system

Service management

Centrul SIDA

Secţia de consiliere şi testare voluntară

Organizaţii non-guvernamentale

Spitale municipale, cabinete de consiliere

şi testare voluntară (20)

Spitale raionale, cabinete de consiliere

şi testare voluntară (39)

Departamentul Instituţiilor

Penetenciare, cabinete de consiliere

şi testare voluntară(8)

ONG 1

ONG 2

ONG 3

SM 1

SM 2

SM 3

SR 1

SR 2

SR 3

Cabinetul de consiliere şi

testare voluntară 1





Ministerul Sănătăţii

Grupul tehnic de lucru – consiliere şi

testare voluntară

Serviciul de Consiliere şi Testare Voluntară

Service management

Centrul SIDA

Laboratorul de diagnosticare şi referinţă

Instituţia medico-sanitară publică Centrele

medicilor de familie

Instituţia medico-sanitară publică

„Spitalele Municipale”Organizaţiile non-guvernamentale

Instituţia medico-sanitară publică spitalele raionale,

municipale

Centre de sănătate

Instituţiile medicale ale Departamentului

Instituţiilor penitenciare (DIP)

Grupul tehnic de lucru – supraveghere epidemiologică şi de santinelă

Serviciul diagnostic de laborator HIV/SIDA


Laboratorul 1

Laboratorul

2

Laboratorul 3

Laboratorul 4

Laboratorul 5

Laboratorul 6

Laboratorul 7

Laboratorul 8

Laboratorul 9

Laboratorul 10

Laboratorul 11

Laboratorul 12

Laboratorul 13

Laboratorul 14

Laboratorul 15

Laboratorul 16

Service management

Grupul Tehnic de lucru tratament şi

îngrijiri

Tratament Antiretroviral şi Îngrijiri

Centrul SIDA

Instituţia medico-sanitară publică Spitalul Municipal Bălţi

Instituţia medico-sanitară publică

raionul Cahul

Spitalul Clinic de Boli Infecţioase „Toma Ciorbă”


Penetenciare


PenetenciareTiraspol

Spitalul Râbniţa

Serviciul specializat al IMSP spitalelor

municipale, raionale (Cabinetul medicului

infecţionist)

„Centrul SIDA” Tiraspol

Spitalul Bender

Serviciul specializat al spitalelor

municipale, raionale (Cabinetul medicului

infecţionist)

Centrul Naţional de Management în

Sănătate


AIDS Center (I)

The center provides the foundamentation of public health policies and strategies, developed projects of normative acts, regulations and methodologies and other papers, insures, highly specialised activities and expertise in the HIV/AIDS compartment

Centrul de Prevenire şi Control al infecţiei HIV/SIDA Vicedirector în supravegherea epidemiolologică a

infecţiei HIV/SIDA

Sector Coordonare a activităţilor de

prevenire, control şi tratament al

infecţiei HIV/SIDA

Secţia prevenire şi comunicare

Laboratorul de diagnosticare şi

referinţa

Şecţia Consiliere şi Testare Voluntară

Secţia supraveghere şi

studii epidemiologice

AIDS Center (II)Methodical and practical support in the surveillance and

control of HIV/AIDS infection

The development and monitoring together with the partners of the National Program for the Prevention and Control of the HIV/AIDS infection and STI for the period 2011-2015

Developing a legal and normative framework which would reflect international and EU standards

Surveillance and evaluation of the epidemical situation, monitoring the indicators of the National Program to Prevent and control HIV/AIDS and sexually transmitted diseases

AIDS Center (III)

Organizing and conducting epidemiological studies, including behavioral studies in populational groups with the determination and assessment of behavioral risk factors and development of forecasts

Practical and methodological assistance to government institutions, NGOs in the surveillance, prevention, treatment and support for people with HIV / AIDS

Facilitating public access to information and shaping public opinion on the state policy to prevent the spread of HIV, treatment monitoring and support for people living with HIV, preventing discrimination

AIDS Center (IV)

Planning, monitoring and coordinating activities related to diagnosis, ARV and opportunistic infections treatment, palliative care and prevention of mother to child transmission

Providing strategic framework and implementation of activities related to human resources capacity building through trainings, continuous education, conferences and workshops

Planning and coordination of activities related to curriculum development, operational standards (standards, guidelines, protocols, training manuals)

AIDS Center (V)

Planning and coordinating activities related to public relations, relations with the mass-media, website management

Planning and coordinating activities related to program monitoring, routine reporting, national reporting

Planning and coordinating of reporting related to the National Program for Prevention and Control of HIV/AIDS, on the international treaties, conventions and documents signed by the Government

Cooperation with the WHO, UNAIDS, UNICEF and other international organizations active in the HIV/AIDS field, under agreements concluded at the Government level through the Ministry of Health

Ministry of Labour, Social Protection and FamilySupport, consulting and cooperation with social and non-

governmental organizations in preventing HIV/AIDS and STIs

Coordination of social interdepartmental support with local authorities and NGOs

Provision of social assistance for people living with HIV/AIDS and their families through the territorial social assistance system and community centers

Ministry of Education (I)

Establish, insure and optimise the functioning of the unique system of forming life skills and promotion of a healthy lifestyle in preventing HIV/AIDS and STIs, of youth studying in educational institutions

CNCSecretariat

GTL Prevenire şi comunicare

Ministrerul Educaţiei

Direcţiile Învăţământ, Tineret şi Sport

Teritoriale

Şcoli Profesional-Tehnice

ColegiiInstituţii Superioare

de Învăţământ

ONGInstituţii Medii de

Învăţământ

Centrul SIDA

Ministry of Education (II)

Development and monitoring of the “Life skills” curriculum

Organizing and carrying out continuous training and preparing of teaching staff on the subject targeted

Develop and publish educational and methodical materials for teachers, pupils, students and parents

Creating conditions to involve students of the "Nicolae Testemitanu" State University of Medicine and Pharmacy and students of medical colleges and pedagogical education institutions in voluntary activities of prevention programs

Ministry of youth and sports

Cooperation with local and central public administration authorities in carrying out prevention activities undertaken by youth experts and NGOs

CNCSecretariat

GTL Prevenire şi comunicare

Ministrerul Tineretului şi Sportului

Primăria locală ONG

Centrul SIDA

Direcţiile Învăţământ, Tineret şi Sport Teritoriale



Ministry of Internal Affairs Fighting ilicit drug trafficking and ilicit drug business.

Training personnel on HIV/AIDS, STI issues

The compulsory introduction of the "Prevention of AIDS, STIs and drug addiction" subject in the staff training curriculum;

Ensuring control over compliance with rules on combating pornography, sexual violence and drug addiction

Ministry of Finance

Providing financial support within the means provided by the state budget law for the respective period, in order to accomplish the activities planned in this program

Auditing of funds used in implementing the "National program for the prevention and control of HIV/AIDS and STIs for the 2011 - 2015 period"

Ministry of External Affairs and European Integration

Informing foreign citizens, through embassies and consulates, upon opening a visa, on the basic provisions of the Moldovan legislation on HIV / AIDS

Participation in international forums held in the field of HIV/AIDS

Protecting rights and interests of Moldovan citizens abroad, as regards HIV/AIDS prevention

Ministry of Justice

Examine the current legal framework and its harmonization with international standards for securing and defending the rights of persons with HIV/AIDS, including those deprived of their liberty

Insuring the organisation of activities and implementation of measures to prevention and fight HIV/AIDS and STIs in prisons by further implementation of harm reduction programs and substitution treatment

Provide specific treatment, social and palliative care for people with HIV/AIDS deprived of their liberty

Training DPI staff on issues of HIV/AIDS prevention and control

Providing the readaptation of prisoners to society after their release

Local public administration authoritiesCreation of inter-territorial and multi-

sectoral commissions for the prevention of HIV/AIDS and STIs

Allocation of special funds to local budgets for the priority financing of major strategies and activities specified in territorial plans

Strengthening state institutions and NGO activities in the implementation of regional programs.

Administraţia Publică locală

CCM Secretariatul

Consiliul municipal, raional

Vicepreşedintele raionului, primarul de

municipiu

Comisia multidisciplinară pentru prevenirea şi controlul

HIV/SIDA cu funcţii de organizare şi control,

monitorizarea şi evaluarea programelor teritoriale HIV/

SIDA

Centrul de sănătate publică

Instituţia medico-sanitară publică Spitalul Raional,

municipal

Instituţia medico-sanitară Centrul

Medicilor de Familie, Asociaţia Medicală

Teritorială

Direcţia Învăţământ, Tineret şi Sport

Direcţia Protecţie Socială

Comisariatul raional de poliţie

Direcţia Finanţe

Sectorul Organizaţiilor non-

guvernamentale

Centrul SIDA

Non-Governmental Organisations (I)

Development and accomplishment of educational programs

Consiliul Naţional de Coordonare

Consiliul de experţi

Secretariatul Consiliului Naţional

de Coordonare

Grupul Tehnic de Lucru 1








Centrul SIDA

Reţele de Organizaţii non-guvernamentale

Liga PTH Reţeaua SIDA

Fundaţia SOROSCentrul PAS

ONG 1

ONG 3

ONG 2

ONG 1

ONG 3

ONG 2

ONG 1

ONG 3

ONG 2

Organizaţii non-guvernamentale

Non-Governmental Organisations (II)

Participation in the development of policies and programs to prevent and control HIV/AIDS and STIs

Providing aid and support services to HIV positive people and AIDS patients

Carrying out preventive work in groups with high risk of infection

Organizing and training volunteer groups among people living with HIV / AIDS

Conducting preventive, educational and support activities among vulnerable groups

Attracting additional financial resources for projects and programs in the field

Mass-media

Creating and implementing special TV and radio programs and broadcasts and publishing printed press articles dedicated to HIV/AIDS, STIs and drug addiction

Organizing campaigns for prevention of discrimination and social ostracisation of people with HIV / AIDS

Usage, abidance and promotion of a non-discriminatory language in articles on HIV/AIDS/STI

XXI CENTURY MEDICINE IS BASED ON THE ISSUES OF HEALTHY PEOPLE BASED ON

THE FOLLOWING SCHEME:

Successor of initiated reforms:

- Health protection law, 1995; - Reorganisation and reform of the Primary Healthcare, started in 1997;- Law on compulsory health insurance, 1998;- Reorganisation of Emergency Medical Assistance, 2003;- Implementing Compulsory Health Insurance, 2004;- Reorganisation of the state public health service, 2009

Demographic indicators

30

Population mortality by main causes of death in the year 2010

Dynamic of total healthcare expenses and their share in the GDP

Sources of financing for healthcare, year 2010

Expense structure 2010

State burden in the financing of the healthcare system

Optimising collections and financial allocations

Financial protection of people having health problems

Equity in financial contributions for health

Access to a well defined health services package

Financial sustainability of the health system

Transfer of the financial burden from the State Budget to the Consumer through AOAM

Emergency healthcare

Primary healthca

re

Hospital service Preventive medicine service

- 1 NPHC

- 34 CSP

- 2 Municipal CSP

-18 Republican Hospitals

- 41 substations

-85 Emergency healthcare points

- 49 Family doctors centres (CMF)

-242 Health Centres (CS), inclusiv 47 autonomous

-618 Family doctor offices (OMF), including 62 autonomous

-359 Health offices, inclusiv 38 autonomous

-34 District Hospitals

-10 Municipal Hospitals - 11 Stomatological clinics

- 5 area stations

Percentage of doctors and specialists with medium education per 10.000 population

EliminaElimination oftion of bar bareeieriers and s and deficiendeficiencies in the cies in the activitactivity of y of

healthcarehealthcare servic serviceses

Creation of the local integrated service network;

Organising common medical councils;

Exclusion of the chaotic circulation of patients in the system;

Perfectarea sistemului de referiri, excluderea trimiterilor la internare prin Consiliul Medical Consultativ.

Creation of the local integrated service network;

Organising common medical councils;

Exclusion of the chaotic circulation of patients in the system;

Improving referal system, exclusion of referals for hospitalisation through the Consultative medical council.

Population access to compensated Population access to compensated medicationmedication

163

275

384

486

611

749

12 20 20 21 27 30

9078535352

30

0

50100

150

200250

300

350400

450

500

550600

650

700750

800

2005 2006 2007 2008 2009 2010

Denumiri comune internaţionale

Denumiri comerciale

Grupe farmacoterapeutice

With the purpose of organising a transparency in the formation of medication prices, the Service for examination and registering of manufacturers’ prices was created.5.370 positions registered in the price catalogue, showing a 29,7% decrease

OptimiOptimisation of management and healthcare sation of management and healthcare provision servicesprovision services

••• Organization• Payment(remunerat

ion)

Abilities to convince

Condición de Salud

Equidad y Acceso

Efectivdad yCalidad

Sustenabilidad Financiera

Productividad yEficiencia

Particapación social

Protección contraRiesgo financiero

SatisfacciónUsuarios

Intermediary objectives

• RegulationFinancing

••

Health conditions

Access

Quality

Equity in financing

Productivity and efficiency

Social participation

Financial risk protection

User satisfaction

Final objectivesInstruments

•

Thank you!!!

MANAGEMENT of the national program to prevent and control HIV/AIDS and STI for the 2011-2015 period...

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Transcript of MANAGEMENT of the national program to prevent and control HIV/AIDS and STI for the 2011-2015 period...