AMERICAN INTERNATIONAL HEALTH ALLIANCE ARMENIA PARTNERSHIP PROGRAM 1998 – 2004 FINAL REPORT Submitted to: USAID/Armenia July 2005 1212 New York Ave., NW, Suite 750, Washington, DC 20005 Tel: (202) 789-1136 Fax: (202) 789-1277 www.aiha.com ACKNOWLEDGEMENTS The American International Health Alliance (AIHA) wishes to express its sincerest gratitude to the countless Armenian and American partners who gave so generously of themselves to the partnership program in Armenia. The program was successful because these individuals demonstrated the courage and commitment to change; the patience, dedication, and hard work to gain new knowledge and skills; and a generous spirit of trust and collaboration. Together they made significant contributions to improving healthcare services and delivery for the people of Armenia. AIHA also thanks the United States Agency for International Development (USAID) for the opportunity and privilege of working in Armenia and for its support of the partnership program. And finally, AIHA gratefully acknowledges the contributions of dedicated staff in its regional and Washington, DC, offices in managing and implementing the program and preparing this final performance report. IHA’s mission is to advance global health through volunteer-driven partnerships that mobilize communities to better address healthcare A priorities while improving productivity and quality of care. Founded in 1992 by a consortium of American associations of healthcare providers and of health professions education, AIHA is a nonprofit organization that facilitates and manages twinning partnerships between institutions in the United States and their counterparts overseas. It has supported to date 116 partnerships linking American volunteers with communities, institutions, and colleagues in 22 countries in a concerted effort to improve healthcare services. Operating with funding from the United States Agency for International Development (USAID), the Health Resources and Services Administration (HRSA) of the US Department of Health and Human Services, the Library of Congress, the Susan G. Komen Breast Cancer Foundation, and other organizations, AIHA’s programs represent one of the US health sector’s most coordinated responses to global health concerns. American International Health Alliance i Armenia Partnership Program Final Report, July 2005 TABLE OF CONTENTS Acknowledgments...............................................................................................................................................i Table of Contents ..............................................................................................................................................ii Acronyms & Abbreviations.............................................................................................................................iii I. EXECUTIVE SUMMARY.......................................................................................................................1 II. PROGRAM OVERVIEW A. Introduction....................................................................................................................................4 B. AIHA Partnership Model .............................................................................................................5 C. Program Design..............................................................................................................................6 III. PROGRAM RESULTS A. Partnerships................................................................................................................................11 A.1 Partnership Summaries 1. Yerevan/Boston, Massachusetts, 1999......................................................................11 2. Yerevan/Los Angeles, California, 1999.....................................................................13 3. Armavir/Galveston, Texas, 1999-2004......................................................................14 4. Gegarkunik/Providence, Rhode Island, 1999-2004.................................................17 5. Lori/Los Angeles, California, 1999-2004..................................................................19 6. Lori/Milwaukee, Wisconsin, 2003-2004....................................................................21 7. Yerevan/Birmingham, Alabama, 1999-2002.............................................................22 8. Yerevan/Washington, DC, 2000-2004 ......................................................................23 A.2 Key Partnership Challenges and Lessons Learned .......................................................25 B. Cross-Partnership Programs .................................................................................................26 B.1 Emergency and Disaster Medicine .................................................................................27 B.2 Healthcare Management...................................................................................................29 B.3 Learning Resource Centers .............................................................................................31 B.4 Neonatal Resuscitation.....................................................................................................34 B.5 Nursing ...............................................................................................................................36 B.6 Women’s Health................................................................................................................40 C. Success Stories...........................................................................................................................43 D. AIHA Conferences ...................................................................................................................45 E. Mid-term Evaluation ...............................................................................................................47 IV. CONCLUSIONS ...................................................................................................................................48 APPENDIX A: Additional Information on Learning Resource Centers..............................................50 American International Health Alliance ii Armenia Partnership Program Final Report, July 2005 ACRONYMS & ABBREVIATIONS AACA Armenian American Cultural Association AAWC Armenian American Wellness Center AIHA American International Health Alliance ANA American Nurses Association ANCC American Nurses Credentialing Center ANIH Armenian National Institute of Health AONE American Organization of Nurse Executives ASTP Armenian Social Transition Program AUA American University of Armenia CDC Centers for Disease Control and Prevention CEE Central and Eastern Europe CPG Clinical Practice Guidelines CQI Continuous Quality Improvement EBP Evidence-Based Practice EDM Emergency and Disaster Medicine EMSTC Emergency Medical Services Training Center FMC Family Medicine Center FMTC Family Medicine Training Center HIV/AIDS Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome ICT Information and Communications Technology ICTC Infection Control Training Center INLI International Nursing Leadership Institute LRC Learning Resource Center MOH Ministry of Health NGO Non-Governmental Organization NIS Newly Independent States NRC Nursing Resource Center NRP Neonatal Resuscitation Program NRTC Neonatal Resuscitation Training Center PHC Primary Healthcare STI Sexually-Transmitted Infections TOT Training-Of-Trainers USAID United States Agency for International Development WWC Women’s Wellness Center American International Health Alliance iii Armenia Partnership Program Final Report, July 2005 I. EXECUTIVE SUMMARY Since 1993, AIHA has been creating and managing twinning partnerships that link American and Armenian healthcare professionals to improve both the quality and accessibility of health-related programs and services in Armenia. The first two partnerships established in this Caucasus nation of 3 million people were part of a broader USAID-funded Health Partnerships Program that encompassed the 12 newly independent nations of the former Soviet Union and focused on improving hospital-based care in the Armenian capital of Yerevan. In 1998, USAID awarded AIHA a second round of cooperative agreements to apply its unique volunteer- based partnership model to new regional health reform priorities, to improve the quality and scope of primary healthcare services. Building on the many successes of those earlier partnerships, six new twinning alliances were formed during this second round of funding. Together, the dedicated efforts of partners on both sides have resulted in positive and sustainable changes at the individual, institutional, community, and national levels. Through AIHA’s programs, partners have paved the way for many “firsts” in Armenia—establishing the country’s first school of nursing and baccalaureate program in nursing education at Erebouni Medical Center; pioneering the use of mammograms and Pap smears for the early detection of breast and cervical cancers at the Armenian American Wellness Center; and creating some of the country’s first model primary care centers in Armavir, Gegarkunik, and Lori where patients can access a wide range of clinical services, patient education programs, and peer support groups. Healthcare practitioners have gained life-saving clinical skills at AIHA-sponsored training centers for emergency and disaster medicine, neonatal resuscitation, and primary care. Nursing professionals have been empowered