In the Soviet system, the population was not involved in decisions about their health care. They had limited rights and limited responsibilities; they were unable to choose their primary health care provider and their health care provider generally gave them little information about their condition. Providers, rather than individuals, were responsible for the health of the population. The state provided everything and people did not take responsibility for their own health. Addressing these issues requires redefining both population rights and responsibilities.
This component of the ZdravPlus Project aims to ensure that the people of Central Asia are better informed about personal health care rights and responsibilities. There is a two-pronged strategy to achieve this:
These strategies are supported by multiple
ZdravPlus educates the public on a broad range of primary and preventive health care topics to encourage them to take greater responsibility for their own health by adopting healthy lifestyles, caring for simple health problems at home, and recognizing more complicated problems that require assistance from a health care provider. ZdravPlus health promotion activities address health topics ranging from basic hygiene and maternal and child health to sexually transmitted infections, smoking, and nutrition. The emphasis, however, is on child health and reproductive health, since these are the backbone of the primary care system that the project seeks to strengthen. The impact of these activities is measured through an annual population survey to assess public knowledge on a range of primary health care topics as well as on health reform issues.
ZdravPlus works to enhance public understanding of the health reforms underway in Central Asia and strengthen the population's involvement in these reforms. These activities center on informing the population of their right to enroll with the family/general practice of their choice - a new concept in the region - and helping them choose a practice. They also aim to define and safeguard client rights and to encourage the public to demand high quality health services that are responsive to their needs. Activities take the form of public awareness and policy marketing campaigns to increase public understanding of, participation in, and support for the health reform efforts.
The population involvement component of the project uses many different media to reach the public, including radio and television, posters and brochures, grants to nongovernmental organizations (NGOs), interpersonal communication and other strategies. Some of the more innovative approaches used include audio messages aired at markets while people shop, soap operas, coloring books on health themes for children, art competitions on health topics, songs and theater performances, and marathons and races.
The ZdravPlus grants program helps build the capacities of local NGOs to be catalysts for change in the health sector. Support to NGOs also contributes to democratic transition in Central Asia and the building of civil society. "Small grants" are awarded to health NGOs undertaking community-based public health interventions to improve the health of the Central Asia population and strengthen the link between the community and primary health care facilities. "Implementation grants" are awarded to health NGOs with a membership base, such as associations, to promote the sustainability of the NGO, improve their capacity to offer services to their members, and provide them with tools to become advocates for their members. Technical assistance is provided to grant recipients desiring to become NGOs including legal assistance to register, develop governance mechanisms including boards and by-laws, and to build capacity in concert with Counterpart Consortium.