Through the ZdravPlus Project, The United States Agency for International Development (USAID) provides resources to help the governments of Central Asia to improve the financial sustainability, efficiency, and quality of their health care while preserving equitable access. Implemented by US-based consulting firm Abt Associates and partners , the ZdravPlus Quality Public Health and Primary Health Care in Central Asia Project operates in Kazakhstan , Kyrgyzstan , Tajikistan , Turkmenistan and Uzbekistan .
In these former Soviet Republics , it means focusing attention on reforming the Primary Health Care sector which entails engaging with and advocating change at every level of the Health Care System – national ministries of health, facilities, health care workers and the population.
ZdravPlus works with ministries of health to gain national level acceptance and support for reforms carried out in pilot sites including new health financing structures, new payment mechanisms, and national level prikazes (orders) allowing PHC doctors to expand their scope of practice. Work at the facilities level entails restructuring the system to encourage the population to visit their primary care physician at out-patient facilities, as opposed to going straight to the hospital level, and rationalizing the use of resources in the health care system. This step combines with re-training primary level health care workers in the principals and practices of family medicine and – thus providing better quality, evidence-based care, with a focus on prevention, at a lower cost to the system and the population. In working with the population, ZdravPlus seeks to inform people not only about how to keep themselves and their families healthy, but also on their rights and responsibilities within the reformed and restructured primary health care system.
Abt Associates has been active in strengthening the health care systems in Central Asia since 1994, through ZdravPlus and predecessor project ZdravReform.
ZdravPlus developed a regional conceptual model for health system strengthening after extensive consultation with government representatives and stakeholders throughout the health care system. The regional model is comprehensive, addressing all aspects of the health care system and implementing them in an integrated way. The conceptual model contains four key components: