EHTP: improving health quality through health technology.

Providing health care effectively and efficiently involves putting together a great variety of resource inputs. Inputs or health technologies (HT) are human and physical resources - facilities and equipment, and consumables including pharmaceuticals. In the complex health system environment, this wide range of technologies and related interventions produce an extraordinary array of different service outputs. The World Health Organization (WHO) embarked in mid-1990s on a major research and development initiative to design a methodology and tool that would allow for optimal, rational and systematic planning and management of healthcare technology interventions. These efforts culminated in the development of the Essential Healthcare Technology Package (EHTP),which has since been successfully applied in countries and by several WHO Technical Programs.

Development of family medicine education in Moldova with Carelift International.

BACKGROUND: As in other former Soviet republics, Moldova's health system has been dependent upon multispecialty and hospital care. The government has undertaken a planning process to develop a primary care-based system utilizing family physicians. Carelift International and Moldova State Medical and Pharmaceutical University joined together to design an educational program to help create a family medicine specialty in the country. METHODS: Introductory concepts were incorporated into a workshop co-sponsored by the World Health Organization, Carelift International, UNICEF and Moldova Ministry of Health. Faculty teams participated in Carelift's 8-week US program, comprising a range of topics in family medicine: educational development at all levels, public health applications, health care organization, insurance, financing, and technology. Training also included 1 week in Finland, a fellowship in Lithuania, an in-country workshop on rural health, and a supplemental 5-week US immersion program. OUTCOMES: A Department of Family Medicine was established, and a residency program instituted. It has already been strengthened with a 2-week introduction to the specialty, and rotations in family practice centers. Continued improvements and updates are planned. Urban and rural model family practice centers serve concurrent purposes of teaching, demonstrating and health care. Carelift shipped equipment for the principal center and a department library, and is equipping a teaching family practice center near the university. The Society of Family Physicians of Moldova was founded. The introduction of family medicine as a discipline into the health system of Moldova could be a valuable model for other former Soviet republics.