Addressing threats to sustainable reproductive health services
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ADDRESSING THREATS TO SUSTAINABLE REPRODUCTIVE HEALTH SERVICES. Gabriela Paleru, M.D. Susan Monaghan, Dr.P.H. USAID/ROMANIA. ● Children dying of AIDS ● Babies dying due to the nosocomial infection ● Disease outbreaks ● Residents on strike for their salaries.

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ADDRESSING THREATS TO SUSTAINABLE REPRODUCTIVE HEALTH SERVICES

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Addressing threats to sustainable reproductive health services

ADDRESSING THREATS TO SUSTAINABLE REPRODUCTIVE HEALTH SERVICES

Gabriela Paleru, M.D.

Susan Monaghan, Dr.P.H.

USAID/ROMANIA


Is rh a priority for the health officials

● Children dying of AIDS

● Babies dying due to the nosocomial infection

● Disease outbreaks

● Residents on strike for their salaries

Is RH a priority for the health officials?

Crisis

management


Health systems in ceec

Health systems in CEEC

● Chronic under-funding

● Inefficiency

● Over-staffing

● Resource flowing to urban, currative, and hospital-based care

● Corruption

● Lack of enforcement


Medical care expenditures in romania 2001

Medical Care Expenditures in Romania 2001


How to make the politicians to change priorities

How to make the politicians to change priorities?

Help them:

  • to reallocate resources

  • to ensure transparency in use of public money

    so they will listen when it comes to focusing on RH.


Where the money goes in hospitals top 10 diagnosis alos

12

ALOS US

10

ALOS Rom

8

6

4

2

0

Normal new born

Hypertension

Normal Vaginal

Delivery

Other osteo-muscular

interventions

Back problems

Minor hepatic problems

Apendicectomy w/

complications

Abortion

Cardiac failure

Otitis media

<17 years

Where the money goes in hospitals? top-10 diagnosis ALOS


Where the money goes in hospitals

3,0%

% cases Hungary

2,5%

% cases Romania

2,0%

1,5%

1,0%

0,5%

0,0%

Normal new-born

Hypertension

Normal vaginal delivery

Cardiac failure

Other osteo-muscular

surgical interventions

Minor hepatic problems

Abortion

Back problems

Otitis < 17 years

.

Wherethe money goes in hospitals?


What to do

What to do?

● Admission criteria

● Reduction of ALOS

● Incentives for ambulatory vs. hospital care

● Ensure insurance reimbursement for RH

Hospital PHC

Ambulatory


Hospital waste phc and sustainable rh services

Primary &

Ambulatory Care

● FP

● STI screening

● Breast/Cervical Cancer

● Other preventive programs

Hospital waste  PHC and sustainable RH services

Hospitals


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