In Azerbaijan, a new pilot project shows that when primary health care prioritizes the training of health workers and the empowerment of local communities to take charge of their health, the national health system itself can become stronger and more resilient.
Many people have struggled to access health services in remote and rural areas of the country due to inadequate primary health care services and facilities. The new PROACT-Care project, implemented by WHO through the Universal Health Coverage Partnership (UHC Partnership), is showing that things can change.
Seferov Semed is the local government representative of the town of Goyler in the mountainous region of Shamakhi. He recently attended a WHO opening ceremony for 3 mobile primary health care clinics, which are now visiting these remote areas and providing essential health services.
“What can primary health care do for Shamakhi? People will get their health checked, health services will be easily accessible and people will be informed about health issues,” Seferov says.
The mobile clinics are vehicles that move from village to village carrying medical equipment, supplies and community health workers. They ensure that health care is brought closer to those who cannot travel to health facilities that are far away.
Supporting health workers in rural areas
Located about 100 km west of Baku, the rural region of Shamakhi is home to about 106 000 people whose entry point to the health system are their primary health care facilities.
By focusing on building the capacity of local primary health care workers, the project ensures that rural communities are not left behind in COVID-19 treatment and vaccination efforts in the country. The results and lessons learned from the pilot project will serve as a basis for the nationwide rollout of a strong and resilient primary health care system.
“We have a wonderful chance to strengthen primary health care in Azerbaijan to address the needs of most people,” said Dr Hande Harmanci, WHO Representative in Azerbaijan. “We hope that very soon, we will be able to demonstrate a useful, practical and cost-effective model for the country in collaboration with our national counterparts.”
Through the project, WHO has been training health workers at all levels and engaging community members on important health service issues in order to provide better primary health care services, including preventing and managing chronic diseases.
Understanding the local context
The health system in Azerbaijan is based on the “semashko” model where polyclinics provide both primary care and outpatient specialized services. Other primary health care facilities are village medical clinics and village or town general practitioner clinics.
Currently, the main challenges for the health system are poor infrastructure, absence of medical equipment, shortage of health workers and lack of training – all factors limiting the scope and quality of primary health care services.
The shortage of physicians in rural areas has worsened through a combination of low salaries and existing physicians retiring and not being replaced. Only 8% of all primary health care facilities have a central water supply. As a result, primary health care facilities and services in rural areas are either not operating or are rarely used by the community.
WHO-implemented projects such as PROACT-Care continue to address these issues by emphasizing resilience and capacity-building.
The UHC Partnership is one of WHO’s largest initiatives on international cooperation for universal health coverage and primary health care. It is funded by Belgium; Canada; the European Union; France’s Ministry for Europe and Foreign Affairs; Germany; Irish Aid; Japan’s Ministry of Health, Labour and Welfare; the Grand Duchy of Luxembourg; and by the United Kingdom’s Foreign, Commonwealth and Development Office.
