The project “Promoting integration of the adolescent-oriented services at Primary Health Care system within the ongoing Health Care Reform in Ukraine” was implemented by the Ukrainian Foundation for Public Health with the support of the United Nations Children’s Fund (UNICEF) and aimed at supporting the Ministry of Health in Ukraine in the integration of adolescent-oriented services at Primary Health Care system to improve adolescent health in Ukraine. The pilot project regions are Poltava and Lviv.
AC “Socioconsulting” was responsible for the implementationof the research and project activities, namely:
- analysis of legislation in the field of medical services for adolescents;
- analysis of human resources in 2 pilot regions (using statistical data);
- mapping of services for teenagers in 2 pilot regions;
- evaluating the results of the pilot package of medical services, which was implemented by the employees of the primary health care system within the Project.
Assessment objectives were to obtain sound answers to the following questions:
- How acceptable and convenient on practice are the methodological recommendations and tools developed during the Project, which wereprovided to the medical staff of pilot health care facilities?
- How much has the time spent by health workers on providing a pilot package of services increased, including analyzing changes in the time spent on particular services by doctors and nurses, has their workload changed significantly?
- Has the introduction of a pilot package of services affected the attitude of health professionals towards adolescent patients, interest in the provision of medical services to the latter, including preventive, if so – how exactly?
- Has the procedure for working with adolescents in pilot PHC facilities changed, if so, how exactly?
- Has the medical staff of the pilot PHC facilities received sufficient training to implement the pilot package of services?
- Has the provision of medical services to adolescents become more productive?
Assessment methodology: a comparative analysis of data collected during the baseline(March2018)and final(October 2018)studies.
During the data collection at both stages, identical research methods were used, namely:
- Survey of doctors and nurses on the specifics of their employment, the peculiarities of working with adolescent patients, including the share of the latter in the total number of appeals, the list of services that are most often provided to them, etc. Survey method: semi-structured face-to-face interviews. The sample per each stage was 200 respondents.
- Work timing of doctors’andnurses’operation was held to assess the workload, analyze the cost of working time and the existing organization of work, the ratio of different activities in the work schedule of health workers (patient counseling, manipulation, work with documentation, etc.), the average time needed for counseling services, including for adolescents.
Work timing per each medical worker was carried out for 5 working days to eliminate the differences in the number of appeals on different weekdays. Chronometric monitoring of 8 health workers (4 doctors and 4 nurses) was conducted in each of the project regions. Thus, we’ve organized a total of 80 monitoring days (8 health workers x 2 regions x 5 monitoring days each).