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Article
Publication date: 4 May 2010

Tsovinar Harutyunyan, Anahit Demirchyan, Michael Thompson and Varduhi Petrosyan

The purpose of this study is to focus on the performance of select facilities in Lori and Shirak provinces in Armenia in Spring 2008. This is in response to the deterioration of…

Abstract

Purpose

The purpose of this study is to focus on the performance of select facilities in Lori and Shirak provinces in Armenia in Spring 2008. This is in response to the deterioration of the primary healthcare sector in Armenia.

Design/methodology/approach

The performance assessment focused on the status of several performance indicators, both current and as recalled for 2006. The interviewer‐administered questionnaire addressed access to care, provider relations with community and clients, environment, management, and primary and secondary prevention at the facilities. For each domain, a summative score that ranged from 0 to 3 was computed and a mean score for each facility derived.

Findings

The project has had significant positive impact on facilities' performance. Access to care scores increased from 2.0 in 2006 to 2.5 in 2008; provider relations with community improved from 1.1 to 1.4; environment scores improved from 1.3 to 1.9, facility management improved from 1.4 to 1.7; and prevention efforts increased from 1.3 to 1.9. The overall mean facility score increased from 1.4 to 1.8. Although the scores for small rural clinics increased, their scores were lower than the scores for other facility types.

Originality/value

In the chronic absence of administrative surveillance data, this paper provides valuable information on the status of primary healthcare services in Armenian provinces. It demonstrates the value of interviewer‐administered performance assessments in obtaining data across project sites when internal monitoring of progress is unavailable.

Details

Leadership in Health Services, vol. 23 no. 2
Type: Research Article
ISSN: 1751-1879

Keywords

Article
Publication date: 1 January 2007

Caren Weilandt, Heion Stöver, Josef Eckert and Gregor Grigoryan

The prevalence of hepatitis B, hepatitis C and HIV in a representative sample of the Armenian male adult prison population has been determined and prisoners and staff were…

111

Abstract

The prevalence of hepatitis B, hepatitis C and HIV in a representative sample of the Armenian male adult prison population has been determined and prisoners and staff were anonymously asked on risk behaviours (542 prisoners) and on knowledge, attitude and behaviour towards infectious diseases (348 staff members) Prisoners’ knowledge about the sources of transmission of HIV is quite poor, most of the wrong answers relate to activities in the daily prison life. The acceptance of HIV‐infected inmates tends towards extremely negative attitudes. The reported rate of intravenous drug use was 13.3%, and 51% among those are current injectors. Of the ‘ever injectors’, between 15% and 30% reported high‐risk behaviour. Of particular interest was the fact that the self‐reported HIV test results did not correlate at all with the results of the saliva tests. In the study the prevalence of HIV was 2.4%, a rate which is 27 times higher than in the general population. The prevalence rate for hepatitis B among prisoners is 3.7% and for hepatitis C 23.8%. The most important risk factor for contracting an HCV infection was drug use and the second, time spent in prison within the last 10 years, which is an independent risk factor. A substantial number of prison employees perceive their working condition as risky and themselves as at risk for TB, hepatitis B/C or HIV, but large groups had no idea about infection rates. Regarding HIV and hepatitis, knowledge is poor and patchy. While staff show quite good knowledge regarding the main transmission routes via blood and unprotected sex, a low level of knowledge becomes obvious when considering everyday‐life situations, which may cause fears in such a closed setting like prison. Standards including confidentiality and non‐segregation are not accepted in respect of HIV positive prisoners. Here, attitudes range between ‘inclusion’ and ‘exclusion’, which might express uncertainty and insecurity about the risks HIV‐positive persons carry. The provision of sterile needles for tattooing and sterile syringes and needles for injecting drugs users to prevent the spread of infectious diseases are not agreed by the majority of prison staff.

Details

International Journal of Prisoner Health, vol. 3 no. 1
Type: Research Article
ISSN: 1744-9200

Keywords

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