Ministries of Health

The Ministry of Health (MoH) is the central executive authority on health in the country which directs and, within the range stipulated by the Law, implements inter-sectoral coordination in the field of citizens’ health protection and medical and pharmaceutical education.

 

The principal responsibilities of the Ministry of Health are: to create a state policy for protection of the population’s health, medical science, medical and pharmaceutical education; to ensure provision of safe, effective and qualitative medicines in the country; to organize and develop international collaboration within the range of the Ministry’s competence.

 

Partnership within the Project: playing the leading role among health institutions and organizations in their countries, the MoHs provide opportunities for advocacy, promotion and development of the Project on the national level.

 

Primary health care – polyclinics, family medicine centers

Under the authority of the Ministry of Health, the primary health system is one of the key pillars within the state health system. Primary health care (PHC) is about providing 'essential health care' which is universally accessible to individuals and families in the community and provided as close as possible to where people live and work. It refers to care which is based on the needs of the population. It is decentralized and requires the active participation of the community and family (WHO, 1978: Declaration of Alma-Ata).

 

Local polyclinicsorganize outpatient PHC and family medicine services for adults and children enrolled with them. Moreover, they provide some HIV-related services, including blood collection for HIV tests, sputum smear microscopy, X-ray examination, continuation-phase of TB treatment, and some STI screening tests, including the Wasserman test for syphilis. They also carry out limited activities on HIV prevention such as health promotion and counseling services. Some polyclinics run Trust Points[1] and Friendly Cabinets[2] to provide services for MARPs.

 

Partnership within the Project: the primary health care system is the main structure providing health services on the national level (diagnostics and treatment) for the clients of the Project within the referral system.

 

National TB Centers

National TB Centers (NTC) under the MoH are responsible for overall guidance of scientific, treatment and preventive activities of all phthisiology services on national level. The main objective of the centers is to increase efficiency of diagnostics and treatment services on tuberculosis, develop preventive measures, and improve organizational approaches on TB control.

Jointly with MoHs, the NTCs are fully committed to implementing the Directly Observed Treatment short course strategy (DOTS) comprising: Basic health education; Case detection; Diagnosis; Availability of TB medication staff; Follow-up clients; Confirming of internationally recognized TB control policies or be in the process of adopting them; Experience in providing social support and DPTs persons with active TB; Promote cooperation where the health services are divided into civil and penitentiary services.

 

Services provided by the Oblast and City TB Dispensariesinclude prevention, diagnostics and treatment of TB. Local TB Dispensaries also draw blood for HIV testing from all hospitalized patients. Treatment of TB during the continuation phase of DOTS is integrated into a number of PHC polyclinics.

 

Partnership within the Project: as the principal structure on TB in the countries, the National TB Centers provide support and services on the Project in respect of TB: diagnosis, treatment, counseling for the clients; informing on statistics and trends; commitment to DOTS and other protocols on TB; identification and tracking of treatment outcomes, etc.  

 

Republican (National) AIDS Centers

Under the MoH, the Republican AIDS Centres are responsible for the prevention, diagnosis and treatment of HIV/AIDS. The AIDS Centre offers special medical services free of charge to the general population, people with HIV and others with high-risk behaviour, such as sex workers, and injecting drug users. The Centre performs laboratory diagnosis of HIV and has reference laboratories. The Centre provides treatment to patients with HIV, AIDS. It also organizes epidemiological surveillance and reporting of HIV cases, implements measures to prevent HIV/AIDS and arranges training and advanced education for medical personnel.

 

The key activities of the Center: Provide leadership, vision and strategy for HIV testing and counseling (HTC); Formulate and update national standards and guidelines for HTC; Advocate for and institutionalize quality assurance systems and the quality improvement methodology for HTC; Agree on training curricula for HTC; authorize training manuals and institutions; Ensure that laboratory quality control (QC) and external quality assessment (EQA) systems are established and maintained; Introduce new testing technologies; Forecast, procure, store and distribute equipment, kits, reagents and consumables; Maintain statistics/national database for HTC (e.g. numbers of people tested each year, disaggregated by sex); Conduct monitoring and evaluation (M&E) of the national HTC program; Recognize and share best practices.

 

Oblast and city AIDS Centersare the key implementers of the National HIV Program on a local level. Every suspected case or confirmed case of HIV is referred to the city/oblast AIDS Center, for proper confirmation and further management. AIDS Centers organize a range of preventive and diagnostic services (clinical, biochemical, serological and immunological tests), out-patient treatment and care for PLHIV, ARVT, as well as treatment of opportunistic infections. AIDS Centers also run Trust Points and Friendly Cabinets to provide specific services to MARPs. Within their prevention terms of reference, AIDS Centers are expected to implement outreach programs for their target populations (injecting drug users, sex workers and men who have sex with men).  

 

Partnership within the Project: being a principal structure on HIV in the countries, the Republican AIDS Centers provide support and services on the Project in respect of HIV: diagnosis, treatment (ARV-therapy), counseling (VCT) for the clients; informing on statistics and trends; commitment protocols on HIV, etc. 

 

National Centers for healthy lifestyle promotion

National Centers for healthy lifestyle promotion under their Ministries of Health are charged with providing leadership to disease prevention and healthy lifestyle promotion among the population on national level.

 

The key activities of the Center: Organizational and methodical guidance on development and implementation of wide range programs for healthy lifestyle development and diseases prevention; Development and maintain effective partnerships and collaborations; Bring the public health community together with new and existing partners representing every interested segment of society for implementation of healthy lifestyle development programs and support the needed actions; Scientific support of healthy lifestyle programs; Development and application of new technologies on health promotion among diverse population groups; Provide training and support in health communication, diseases prevention, health strengthening and healthy lifestyle promotion for primary health care practitioners, teachers policy makers; Work with diverse population groups for continuous health education that focuses on prevention and healthy lifestyle choices such as promotion of good nutrition, regular physical activity; abstinence from smoking and other risky behavior; Work with mass media channels on healthy lifestyle promotion.

 

Partnership within the Project: National Centers for healthy lifestyle promotion provide support in development of IEC materials, informational campaigns, methodological approaches, trainings for the staff and volunteers working on the Project, etc.

 

Dermatovenereal Centers/Dispensaries

Services of local Dermatovenereal Dispensaries(STI dispensaries) include early detection and all relevant preventive, diagnostic and treatment services for sexually transmitted infections (STI), both outpatient and inpatient. They also draw blood for HIV testing and require mandatory fluorography for patients referring to in-patient care.

 

Partnership within the Project: the centers provide diagnostics and treatment of STI for the clients of the Project, distribution of condoms, counseling on STI, etc.

 

Narcology Centers/Dispensaries

Local Narcology Dispensaries are another specialized vertical service, responsible for early detection and enrollment of drug-users and alcoholic patients, and the organization of counseling, diagnostic, treatment and rehabilitation services through either outpatient or inpatient services. Among HIV and TB related services, narcological dispensaries draw blood for HIV testing, collect sputum or sometimes perform sputum smear microscopy and perform Wasserman tests for syphilis. Also, consultation and counseling on HIV/AIDS, TB and STIs are reportedly provided.

 

Partnership within the Project: the centers provide counseling, treatment and rehabilitation on drug abuse (in-patient treatment, out-patient treatment) for the Project clients within referral system.