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Project acronym: ImPrim

Project title: Improvement of public health by promotion of equitably distributed high quality primary health care systems

Application call: 2

Priority: 4. Attractive & competitive cities and regions

Project website:

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Lead Partner:

BCC Blekinge Center of Competence
Vårdskolevägen 5
371 81 Karlskrona
SE
Ingvar Ovhed
E-mail: ingvar.ovhed@ltblekinge.se
Phone: +46 (0)455 73 48 14
Fax: +46 (0)455 73 78 30

Project Manager:

BCC Blekinge Center of Competence
Vårdskolevägen 5
371 81 Karlskrona
SE
Karin Chamoun
E-mail: karin.chamoun@ltblekinge.se
Phone: +46 (0)455 73 78 29
Fax: +46 (0)455 73 78 30


Information Manager:

BCC Blekinge Center of Competence
Vårdskolevägen 5
371 81 Karlskrona
SE
Anna Ohlson
E-mail: anna-a.ohlsson@ltblekinge.se
Phone: +46 (0)455 73 78 40
Fax: +46 (0)455 73 78 30



Summary description of the project:

ImPrim – a Primary Health Care flagship project. There are substantial health differences between the countries in the Baltic Sea Region (BSR). These inequalities have a relationship to social problems. The ImPrim project aims at promoting equitably distributed high quality Primary Health Care services in the BSR in order to increase the cost-efficiency of the public health system and more efficiently counteract communicable diseases and health problems related to social factors. Primary Health Care is the level of care nearest to the community. It coordinates care with other community stakeholders and health services and helps to control the costs of the public health systems. Hence, Primary Health Care is an efficient tool for health promotion and disease prevention, and contributes to increasing the attractiveness of regions.The equitable availability of high quality Primary Health Care personnel and resources is a big challenge for all countries around the Baltic Sea and Belarus.

ImPrimt tackles three core areas: Access to Primary Health Care; Financial resources for Primary Health Care; Professional development of Primary Health Care staff. The project has been managed by the Centre for Competence at the Blekinge County Council. Ministries of health, national and regional authorities, universities and professional associations from Sweden, Finland, Estonia, Latvia, Lithuania, Russia and Belarus, and ministries of health from all countries are associated members. In addition to the project countries, the work has been linked with other EU-projects, with British and Danish institutions, among others. The project, which has been awarded flag ship status, was finalised in December 2012. To widen the ImPrim concept a parallel project on eHealth, funded by Swedish Sida BSR Unit, was implemented during 2011 and 2012 with three international thematic conferences.

Postgraduate training in PHC programs for physicians and nurses working outside the health care sector wishing to return to their profession has been offered. The economic impact of returning physicians is huge and of transnational significance. Health Synergy - a model on How to join Primary Health Care and Public Health activities. A model for holistic preventive health care through collaboration and integration of public health and PHC professionals. The advantages and challenges are illustrated in several studies carried out within the framework of the project. The project has achieved important aims in meeting community health care, preventive care and effective clinical management of health problems.The ImPrim project is from many aspects unique in the wide perspective of primary care and public health working on the two levels – basic health care and the overall planning and steering national level. Numerous results with strong impact can be shown from the ImPrim project.


Achievements of the project so far:

Within Remuneration of Primar Health Care (PHC) the results are already overwhelming because of the radical shift in the health budget in Latvia. The Latvian minister of health has acknowledged the importance of ImPrim in the work following the budget changes which shifted resources from hospital services to PHC and introduction of a new Quality Bonus System for PHC was introduced in Latvia in July 2011. The change is part of a long structural reform process, partly also a consequence of the financial crisis which hit Latvia hard. In the framework of ImPrim it has been shown that it is possible to develop PHC to take a larger responsibility in the health system. The strong focus on quality development in the project has been important to show that the content of PHC visits, the medical need of the patient, and the providers ability to contribute to health, are a needed components to complement the traditionally good accessibility.

Within Professional Development the role of the nurse in PHC is accentuated. The projects’ hands-on approach and proximity to clinical work is very important. In all participating countries, groups of nurses have used the medical audit method to advance and claim competence and ambition within their own profession, and vis-à-vis management and administrative levels. In Lithuania results are especially prominent. The nurses clearly aspire to leave their traditional role of assisting and conducting secretarial tasks, to gain independence in their own profession with patient meetings incl. motivational counselling and life style changes.It stresses the differences in competence between doctors and nurses, but also the differences in content of the doctor-patient meeting compared to the nurse-patient meeting. The medical audit method has shown to be an effective clinical tool also for the development of doctors’ skills.

The problem of ‘brain-drain’ is evident in all project countries. The Estonian pilot on “repatriating” doctors and nurses from outside the health sector by offering postgraduate training and preparation to pass required qualification exam is a new way mitigating the effects of emigration, with significant economic impact. The Estonian Ministry of Social Affaires is planning a similar project based on these experiences. Within Regional Planning a Health Synergy model has been developed, emphasizing the responsibility for public health in the provision of PHC, incl. guidelines on how to improve health promotion activities. The regional strategy on containment of antimicrobial resistance and implementation of rational antibiotic has brought forward intensive discussions among general practitioners and narrow specialists from hospitals. A centre for medical audit at Klaipeda University was created and started a study of the use of antibiotics in PHC in case of urinary tract infection.



Project Duration: Sep 2009 - Dec 2012
Approximate total project budget in EUR: 2.671.670,00
ERDF co-financing: 1.958.640,00
ENPI co-financing: 221.130,00
Norwegian national contribution: 0,00

List of partners

Blekinge Centre of Competence, Blekinge County Council
SE-37181 Karlskrona | SWEDEN
Landstinget Blekinge
Region: Sydsverige
Contact person: Ingvar Ovhed
Phone: +46455731000
E-mail: ingvar.ovhed@ltblekinge.se
Web: www.ltblekinge.se
Approximate total partner budget in EUR:712.402,00
ERDF co-financing:528.811,00
ENPI co-financing:0,00
Norwegian national contribution:0,00
Turku University of Applied Sciences (TUAS)
20520 Turku | FINLAND
Joukahaisenkatu 3 A
Region: Etelä-Suomi
Contact person: PhD, MNSc Maika Kummel
Phone: +358 2 263 350
E-mail: maika.kummel@turkuamk.fi
Web: www.tuas.fi
Approximate total partner budget in EUR:218.600,00
ERDF co-financing:163.950,00
ENPI co-financing:0,00
Norwegian national contribution:0,00
Institute of Hygiene
00-128 Vilnius | LITHUANIA
Didzioji 22
Region: Lietuva
Contact person: Vytautas Jurkuvenas
Phone: +370 5 262 4583
E-mail: vjurkuvenas@hi.lt
Web: www.hi.lt
Approximate total partner budget in EUR:331.345,00
ERDF co-financing:281.644,00
ENPI co-financing:0,00
Norwegian national contribution:0,00
The National Health Service
1012 Riga | LATVIA
31k-3 Cesu Street
Region: Latvija
Contact person: Aigars Miezitis
Phone: + 371 67043700
E-mail: aigars.miezitis@vmnvd.gov.lv
Web: www.vec.gov.lv
Approximate total partner budget in EUR:230.390,00
ERDF co-financing:195.831,00
ENPI co-financing:0,00
Norwegian national contribution:0,00
Latvian Family Physicians’ Association
1011 Riga | LATVIA
Brivibas 58
Region: Latvija
Contact person: Sarmite Veide
Phone: +371 67285171
E-mail: sarmite@lgaa.lv
Web: www.lgaa.lv
Approximate total partner budget in EUR:32.760,00
ERDF co-financing:27.846,00
ENPI co-financing:0,00
Norwegian national contribution:0,00
University of Tartu, Medical Faculty
50090 Tartu Ülikool | ESTONIA
Ülikooli 18
Region: Eesti
Contact person: Margus Lember
Phone: +372 7375100
E-mail: margus.lember@ut.ee
Web: www.ut.ee
Approximate total partner budget in EUR:322.000,00
ERDF co-financing:273.700,00
ENPI co-financing:0,00
Norwegian national contribution:0,00
Tallinn Health College
13418 Tallin | ESTONIA
Kännu 67
Region: Eesti
Contact person: Ülle Ernits
Phone: +372 6711701
E-mail: info@ttk.ee
Web: www.ttk.ee
Approximate total partner budget in EUR:128.700,00
ERDF co-financing:109.395,00
ENPI co-financing:0,00
Norwegian national contribution:0,00
Ministry of Social Affairs, Departament of Stastistics and Analysis
15027 Tallin | ESTONIA
Gonsiori 29
Region: Eesti
Contact person: Liis Rooväli, Head of Health Information and Analysis Department
Phone: +372 6269 158
E-mail: Liis.roovali@sm.ee
Web: www.sm.ee
Approximate total partner budget in EUR:19.890,00
ERDF co-financing:16.906,00
ENPI co-financing:0,00
Norwegian national contribution:0,00
Belarussian medical academy for continuous education (BelMAPO)
220013 Minsk | BELARUS
Brovky str. 3
Region: Minskaya Oblastj, g. Minsk.
Contact person: Vjacheslav Grankov
Phone: +375 296579795
E-mail: Grankov8@gmail.ru
Web: www.belmapo.by
Approximate total partner budget in EUR:55.312,00
ERDF co-financing:0,00
ENPI co-financing:0,00
Norwegian national contribution:0,00
Gomel Regional Health Care Authorities
246050 Gomel | BELARUS
Lange str. 5
Region: Gomelskaya Oblastj.
Contact person: Nikolai Vasilkov
Phone: + 232 F107174-87-89
E-mail: uzo@mail.gomel.by
Web:
Approximate total partner budget in EUR:184.287,00
ERDF co-financing:0,00
ENPI co-financing:0,00
Norwegian national contribution:0,00
Klaipeda university
LT 92294 Klaipeda university | LITHUANIA
Herkaus Manto str. 84
Region: Lietuva
Contact person: Arnoldas Jurgutis
Phone: +370 46398560
E-mail: vsk.svmf@ku.lt
Web: www.ku.lt
Approximate total partner budget in EUR:335.688,00
ERDF co-financing:285.335,00
ENPI co-financing:0,00
Norwegian national contribution:0,00
Swedish Committee for International Health care Collaboration (SEEC)
11630 Stockholm | SWEDEN
Folkkungagatan 129
Region: Stockholm
Contact person: Ragnar Norrby, Director General
Phone: +4684413350
E-mail: info@oek.se
Web: www.oek.se
Approximate total partner budget in EUR:100.289,00
ERDF co-financing:75.217,00
ENPI co-financing:0,00
Norwegian national contribution:0,00